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Organization
PATHOLOGY ASSOCIATES OF TYLER PA
Active
Organization
PATHOLOGY ASSOCIATES OF TYLER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW KULAGA M.D. (PRESIDENT)
(903) 593-0481
Entity
Organization
Contact information
Practice address
1726 S BECKHAM AVE, TYLER, TX 75701-4465
(903) 593-0481
(903) 592-0555
Mailing address
1726 S BECKHAM AVE, TYLER, TX 75701-4465
(903) 593-0481
(903) 592-0555
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110790601
—
TX
05
—
110790603
—
TX
01
—
690039090
RAILROAD MC
TX
01
—
CL8037
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/03/2006
Last updated
07/18/2022
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