Organization
PATHADVANTAGE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRA J GILLESPIE MD (MEDICAL DIRECTOR)
(214) 219-5880
Entity
Organization
Contact information
Practice address
5327 N CENTRAL EXPY, SUITE 300, DALLAS, TX 75205-3361
(214) 219-5880
(214) 219-5881
Mailing address
5327 N CENTRAL EXPY, SUITE 300, DALLAS, TX 75205-3361
(214) 219-5880
(214) 219-5881
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220033145
MCARE RR
TX
Enumeration date
04/24/2007
Last updated
07/25/2011
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