Organization Active NPI

Medical Center Laboratory

  • Clinical Medical Laboratory
  • Waxahachie, TX
National Provider Identifier
1336178193
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MEDICAL CENTER LABORATORY
Practice address
201 Ferris Avenue
Waxahachie, TX 75165
Phone
(972) 937-7310
Fax
(972) 923-7190
NPI assigned
Jul 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Brett McKinney Thacker, MDNPI 1679502538
Title
Owner Medical Director
Phone
(972) 937-7310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X TX Primary

Addresses

Primary practice location

201 Ferris Avenue
Waxahachie, TX 75165

Mailing address

201 Ferris Avenue
Waxahachie, TX 75165
Phone (972) 937-7310

National Provider Directory

National Provider Directory

Locations

201 Ferris Ave
Ste D
Waxahachie, TX 75165
Phone (972) 937-7310

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336178193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 FERRIS AVENUE",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "75165",
            "telephone_number": "972-937-7310",
            "fax_number": "972-923-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 FERRIS AVENUE",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "75165",
            "telephone_number": "972-937-7310",
            "fax_number": "972-923-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THACKER",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "MCKINNEY",
        "authorized_official_title_or_position": "OWNER MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "972-937-7310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxahachie, TX

Sources for this page

  • 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.