NPIMap

Organization Active NPI

Memorial Pathology Consultants PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Shenandoah, TX
National Provider Identifier
1477519379
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
MEMORIAL PATHOLOGY CONSULTANTS PA
Practice address
9250 Pinecroft Dr Dept of
Shenandoah, TX 77380-3218
Phone
(832) 412-8670
Fax
(713) 456-5202
NPI assigned
Apr 21, 2006
Last updated
Oct 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Authorized official

Name
Richard Wayne Brown, MDNPI 1255394615
Title
President
Phone
(832) 412-8670

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0500X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

9250 Pinecroft Dr Dept of
Shenandoah, TX 77380-3218

Mailing address

PO Box 671130
Dallas, TX 75267-1130
Phone (512) 861-0080

Other identifiers 1

IdentifierTypeStateIssuer
183707201MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051109001100 TX Part B Supplier - Clinic/Group Practice 0941262778 Receives reassigned benefits from 24 practitioners
2 other NPIs on this enrollment
Practice locations: Houston, TX; Shenandoah, TX; Pearland, TX; Cypress, TX

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
Memorial Pathology Consultants PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1477519379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 671130",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752671130",
            "telephone_number": "512-861-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 PINECROFT DR DEPT OF",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803218",
            "telephone_number": "832-412-8670",
            "fax_number": "713-456-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL PATHOLOGY CONSULTANTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2021-10-20",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-412-8670",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183707201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.