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Organization

GULF COAST PATHOLOGY PROGRAM PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL JAMAINE DAVIS (CHIEF OPERATIONS OFFICER)
(954) 507-6764
Entity
Organization

Contact information

Practice address
9711 N SAM HOUSTON PKWY E, HUMBLE, TX 77396-4482
(281) 348-8279
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
10/12/2021
Last updated
10/12/2021
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