Organization
MOUSHIRA A EBRAHIM
Active
Other names
Pathology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MOUSHIRA ANWAR EBRAHIM MD (PRESIDENT)
(903) 454-4051
Entity
Organization
Contact information
Practice address
4818 WELLINGTON ST, SUITE 4, GREENVILLE, TX 75402-6010
(903) 455-4051
(903) 455-4051
Mailing address
PO BOX 1888, GREENVILLE, TX 75403-1888
(903) 455-4051
(903) 454-1716
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
094948902
—
TX
Enumeration date
03/21/2006
Last updated
09/29/2016
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