Organization
NORTHEAST PATHOLOGY GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLINE L. VALDES MD (PRESIDENT/OWNER)
(361) 575-1111
Entity
Organization
Contact information
Practice address
2701 HOSPITAL DRVIE, VICTORIA, TX 77901-5748
(361) 575-1111
(361) 573-5012
Mailing address
PO BOX 207048, DALLAS, TX 75320-7048
(713) 559-6929
(713) 559-6928
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374209001
—
TX
01
—
CQ4039
RAILROAD MEDICARE
TX
Enumeration date
12/06/2005
Last updated
01/25/2018
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