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Contact Information

AMERIPATH LUBBOCK 5.01(A) CORPORATION
1401 PENNSYLVANIA AVE
FORT WORTH, TX76104-2113
 Phone: 713-432-1100
 Fax: 713-432-0221
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for AMERIPATH LUBBOCK 5.01(A) CORPORATION

NPI Number 1700860434
LBN Legal business name AMERIPATH LUBBOCK 5.01(A) CORPORATION
Authorized official DARREN WHEELER - (VICE PRESIDENT)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/06/2005
Last updated 09/05/2024 - More than a year ago
Identifiers
TX License # 45D0701182
OK Medicaid 200393940A
TX Medicaid 121877803
TX Other 0T841 BCBS
TX Other 45D0914073 CLIA
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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