Provider Demographics
NPI:1841338076
Name:ORAL PATHOLOGY ASSOCIATES LP
Entity type:Organization
Organization Name:ORAL PATHOLOGY ASSOCIATES LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-828-8118
Mailing Address - Street 1:PO BOX 8887
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75404-8887
Mailing Address - Country:US
Mailing Address - Phone:214-828-8110
Mailing Address - Fax:214-828-8306
Practice Address - Street 1:3302 GASTON AVE
Practice Address - Street 2:SUITE 225
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2013
Practice Address - Country:US
Practice Address - Phone:214-828-8110
Practice Address - Fax:214-828-8306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D0659611291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX090093802Medicaid
TX090093802Medicaid