Organization
WACO PATHOLOGY ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID MANLY MCTAGGART M.D. (PRESIDENT & SUPERVISING PHYSICIAN)
(254) 752-9621
Entity
Organization
Contact information
Practice address
601 W HWY 6, SUITE 111, WACO, TX 76710-5591
(254) 752-9621
(254) 752-8378
Mailing address
PO BOX 21509, WACO, TX 76702-1509
(254) 752-9621
(254) 752-8378
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080204301
—
TX
Enumeration date
09/16/2006
Last updated
04/30/2009
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