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Organization
NORTH TEXAS MEDICAL LABORATORY
Active
Organization
NORTH TEXAS MEDICAL LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN STRATE MD (PRESIDENT)
(940) 692-5888
Entity
Organization
Contact information
Practice address
5420 KELL WEST BLVD., WICHITA FALLS, TX 76301
(940) 692-5888
Mailing address
5420 KELL WEST BLVD., WICHITA FALLS, TX 76301
(940) 692-5888
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00M224
BLUE SHIELD
TX
05
—
141630701
—
TX
01
—
CS4601
RR MEDICARE
TX
Enumeration date
09/11/2006
Last updated
04/21/2008
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