NPIMap

Organization Active NPI

Waco Pathology Associates, P.a.

  • Anatomic Pathology & Clinical Pathology Physician
  • Waco, TX
National Provider Identifier
1275639007
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
WACO PATHOLOGY ASSOCIATES, P.A.
Practice address
601 W Hwy 6
Suite 111
Waco, TX 76710-5591
Phone
(254) 752-9621
Fax
(254) 752-8378
NPI assigned
Sep 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

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

Authorized official

Name
Dr. David Manly McTaggart, M.D.
Title
President & Supervising Physician
Phone
(254) 752-9621

Specialties & licenses 1

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

Addresses

Primary practice location

601 W Hwy 6
Suite 111
Waco, TX 76710-5591

Mailing address

PO Box 21509
Waco, TX 76702-1509
Phone (254) 752-9621

Other identifiers 1

IdentifierTypeStateIssuer
080204301MedicaidTX

National Provider Directory

National Provider Directory

Locations

3115 Pine Ave
Ste 108
Waco, TX 76708
Phone (254) 752-9621

3115 Pine Ave
Waco, TX 76708
Phone (254) 741-1185

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241049600000",
    "number": "1275639007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21509",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767021509",
            "telephone_number": "254-752-9621",
            "fax_number": "254-752-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W HWY 6",
            "address_2": "SUITE 111",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767105591",
            "telephone_number": "254-752-9621",
            "fax_number": "254-752-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACO PATHOLOGY ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2009-04-30",
        "status": "A",
        "authorized_official_last_name": "MCTAGGART",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MANLY",
        "authorized_official_title_or_position": "PRESIDENT & SUPERVISING PHYSICIAN",
        "authorized_official_telephone_number": "254-752-9621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080204301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; 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.