Tissue Techniques Pathology Labs LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

TISSUE TECHNIQUES PATHOLOGY LABS LLC

Practice address

1850 Crown Dr
Suite # 1112
Dallas, TX 75234-9414

Phone

(972) 241-6277

Fax

(972) 241-4747

NPI assigned

Nov 3, 2006

Last updated

Mar 13, 2018By 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

Mr. Frederick L Siena

Title

Cfo

Phone

(972) 241-6277

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520899200000",
    "number": "1497834295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 CROWN DR",
            "address_2": "SUITE # 1112",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752349414",
            "telephone_number": "972-241-6277",
            "fax_number": "972-241-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CROWN DR",
            "address_2": "SUITE # 1112",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752349414",
            "telephone_number": "972-241-6277",
            "fax_number": "972-241-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TISSUE TECHNIQUES PATHOLOGY LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2018-03-13",
        "status": "A",
        "authorized_official_last_name": "SIENA",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "972-241-6277",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "CL5036",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200027600A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4058646",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140740501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; 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.