Organization
MPL INC
Active
Other names
Medical and Pathology Lab
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN OLIVER (CFO)
(214) 871-8616
Entity
Organization
Contact information
Practice address
402 N 5TH ST, LONGVIEW, TX 75601-6529
(903) 758-8511
(903) 757-5033
Mailing address
PO BOX 840127, DALLAS, TX 75284-2416
(214) 886-4700
(214) 871-8609
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154357101
—
TX
Enumeration date
03/01/2006
Last updated
03/26/2024
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