Organization
PATHOLOGISTS BIO-MEDICAL LABORATORIES PLLC
Active
Other names
Pathologists Bio-Medical Laboratories LLP
Organization subpart
No
Provider details
NPI number
Authorized official
PETER A. DYSERT II M.D. (PRESIDENT)
(214) 823-6492
Entity
Organization
Contact information
Practice address
1111 NORTHPOINT DR, COPPELL, TX 75019-3831
(972) 966-7830
Mailing address
3600 GASTON AVE, WADLEY TOWER, SUITE 261, DALLAS, TX 75246-1800
(214) 818-9100
(214) 818-9170
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D0481682
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127290803
—
TX
01
—
690003975
RAILROAD MEDICARE
TX
Enumeration date
07/03/2006
Last updated
09/06/2023
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