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Organization
GULF COAST PATHOLOGY PROGRAM PLLC
Active
Organization
GULF COAST PATHOLOGY PROGRAM PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMAINE DAVIS (CHIEF FINANCIAL OFFICER)
(561) 402-4256
Entity
Organization
Contact information
Practice address
7600 FANNIN ST, HOUSTON, TX 77054-1906
(713) 791-7126
Mailing address
PO BOX 746559, ATLANTA, GA 30374-6559
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
11/10/2023
Last updated
11/10/2023
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