Organization
MCD PATHOLOGY LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JO ELLEN KRUEGER M.D. (PARTNER)
(972) 566-7283
Entity
Organization
Contact information
Practice address
7777 FOREST LANE, DEPARTMENT OF PATHOLOGY, DALLAS, TX 75230-2584
(972) 566-7283
(792) 566-7183
Mailing address
7777 FOREST LANE, DEPARTMENT OF PATHOLOGY, DALLAS, TX 75230-2584
(972) 566-7283
(792) 566-7183
Taxonomy
Speciality
Code
Description
License number
State
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120722702
—
TX
01
—
PM89
BLUE CROSS
TX
Enumeration date
07/07/2006
Last updated
05/10/2022
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