El Paso Pathology Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

EL PASO PATHOLOGY LABORATORY

Doing business as

Path Lab El Paso

Practice address

1201 E Schuster Ave
4B
El Paso, TX 79902-4672

Phone

(915) 533-1300

Fax

(915) 533-1300

NPI assigned

Oct 17, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

WM Gordon McGee, MD

Title

Medical Director

Phone

(915) 533-1300

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Path Lab El Paso Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard D Fernandez, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Rome, GA
  • NPI 1558351437
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093704629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 E SCHUSTER AVE",
            "address_2": "4B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799024672",
            "telephone_number": "915-533-1300",
            "fax_number": "915-533-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E SCHUSTER AVE",
            "address_2": "4B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799024672",
            "telephone_number": "915-533-1300",
            "fax_number": "915-533-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL PASO PATHOLOGY LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "WM",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "915-533-1300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1677932",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77323815",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "CL5126",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Path Lab El Paso",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in El Paso, TX
• Providers in El Paso, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.