Organization
NTX PATHOLOGY PROGRAM, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMAINE DAVIS (CHIEF OPERATIONS OFFICER)
(561) 402-4256
Entity
Organization
Contact information
Practice address
500 W MAIN ST, LEWISVILLE, TX 75057-3641
(469) 370-2280
Mailing address
PO BOX 745390, ATLANTA, GA 30374-5390
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
12/28/2023
Last updated
12/28/2023
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