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Contact Information

EASTERN TEXAS PATHOLOGY LABORATORIES, LLC
134 ROSEDALE DR
ATHENS, TX75751-3625
 Phone: 903-675-0080
 Fax: 903-675-0081
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for EASTERN TEXAS PATHOLOGY LABORATORIES LLC · (Female)

NPI # 1154445419
Status Active
Credentials
Entity Individual
Enumeration date 03/19/2007
Last updated 09/16/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • TX License # J2242
  • TX Other 0085PV BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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