Organization
TXAR 501A CORPORATION
Active
Parent organization
AMERIPATH INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERIPATH INC.
Authorized official
EDWARD M KRAMER MD (VICE PRESIDENT)
(610) 550-3003
Entity
Organization
Contact information
Practice address
5405 PLAZA DR, TEXARKANA, TX 75503-1662
(903) 223-5200
(903) 223-5213
Mailing address
14275 MIDWAY RD STE 400, ADDISON, TX 75001-3676
(610) 271-4245
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D0482326
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109469002
—
TX
01
—
690004016
MC RR IL
TX
01
—
HE23
BCBS
TX
Enumeration date
02/01/2006
Last updated
10/03/2019
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