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Organization
EASTERN TEXAS PATHOLOGY LABORATORIES, LLC
Active
Organization
EASTERN TEXAS PATHOLOGY LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES R. OGBURN JR. M.D. (PATHOLOGIST)
(903) 675-0080
Entity
Organization
Contact information
Practice address
134 ROSEDALE DR, ATHENS, TX 75751-3625
(903) 675-0080
(903) 675-0081
Mailing address
134 ROSEDALE DR, ATHENS, TX 75751-3625
(903) 675-0080
(903) 675-0081
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
J2242
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0085PV
BCBS
TX
Enumeration date
03/19/2007
Last updated
09/16/2014
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