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Organization
TXAR 501A CORPORATION
Active
Organization
TXAR 501A CORPORATION
Active
Parent organization
AMERIPATH INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERIPATH INC.
Authorized official
EDWARD M KRAMER MD (VICE PRESIDENT)
(610) 550-3003
Entity
Organization
Contact information
Practice address
2600 SAINT MICHAEL DR, TEXARKANA, TX 75503-2372
(903) 223-5200
(903) 223-5212
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(610) 271-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
04D0872828
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100759020C
—
OK
05
—
109469001
—
TX
01
—
HE23
BCBS
TX
Enumeration date
02/03/2006
Last updated
03/24/2020
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