Provider Demographics
NPI:1669433272
Name:DESERT PATHOLOGY SERVICES, PA
Entity type:Organization
Organization Name:DESERT PATHOLOGY SERVICES, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-264-6215
Mailing Address - Street 1:PO BOX 421479
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77242-1479
Mailing Address - Country:US
Mailing Address - Phone:915-200-1479
Mailing Address - Fax:915-200-7566
Practice Address - Street 1:1801 NORTH OREGON STREET
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3591
Practice Address - Country:US
Practice Address - Phone:915-521-1341
Practice Address - Fax:915-521-1494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM31455859Medicaid
TX173408901Medicaid
TX00518YMedicare PIN