NPIMap

Organization Active NPI

Pathologists Bio-Medical Laboratories PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Dallas, TX
National Provider Identifier
1265477707
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PATHOLOGISTS BIO-MEDICAL LABORATORIES PLLC
Practice address
3500 Gaston Ave
Dallas, TX 75246-2096
Phone
(214) 818-9100
Fax
(214) 818-9170
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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

Authorized official

Name
Peter A. Dysert II, M.D.NPI 1619903226
Title
President
Phone
(214) 818-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X TX Primary

Addresses

Primary practice location

3500 Gaston Ave
Dallas, TX 75246-2096

Mailing address

3600 Gaston Ave
Wadley Tower, Suite 261
Dallas, TX 75246-1800
Phone (214) 818-9100

Other identifiers 2

IdentifierTypeStateIssuer
127290802MedicaidTX
CR0446OtherTXRAILROAD MEDICARE

Other names 1

  • Pathologists Bio-Medical Laboratories LLP Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041112001162 TX Part B Supplier - Clinic/Group Practice 7911961677 Receives reassigned benefits from 68 practitioners
2 other NPIs on this enrollment
Practice locations: McKinney, TX; Plano, TX; Pittsburg, TX; Quitman, TX; Southlake, TX; Trophy Club, TX; Tyler, TX; Victoria, TX…

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pathologists Bio Medica5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3600 Gaston Ave
Ste 2
Dallas, TX 75246
Phone (972) 966-7830

3600 Gaston Ave
Ste 261
Dallas, TX 75246
Phone (214) 818-9100

3500 Gaston Ave
Ste 261
Dallas, TX 75246
Phone (214) 818-9100

5550 Frisco SQ Blvd
Frisco, TX 75034

5450 Clearfork Main St
Ft Worth, TX 76109
Phone (817) 334-1400

700 Walter Reed Blvd
Ste 209
Garland, TX 75042
Phone (972) 494-3657

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

2460 N Ih 35 E
Waxahachie, TX 75165
Phone (463) 800-9500

Practitioners & affiliated clinicians

Practitioners 104

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 104

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568332800000",
    "number": "1265477707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "WADLEY TOWER, SUITE 261",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461800",
            "telephone_number": "214-818-9100",
            "fax_number": "214-818-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462096",
            "telephone_number": "214-818-9100",
            "fax_number": "214-818-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGISTS BIO-MEDICAL LABORATORIES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2019-09-13",
        "status": "A",
        "authorized_official_last_name": "DYSERT",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-818-9100",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127290802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CR0446",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathologists Bio-Medical Laboratories LLP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.