Organization Active NPI

Gulf Coast Pathology Associates PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Dallas, TX
National Provider Identifier
1609449941
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
GULF COAST PATHOLOGY ASSOCIATES PLLC
Practice address
1801 Royal LN Ste 810
Dallas, TX 75229-3169
Phone
(469) 886-4700
Fax
(214) 871-8609
NPI assigned
Jul 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Ms. Linda Y Liston, CPC
Title
Administrator
Phone
(936) 234-9557

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZD0900X
Molecular Genetic Pathology (Pathology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZP0007X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

1801 Royal LN Ste 810
Dallas, TX 75229-3169

Mailing address

1801 Royal LN Ste 810
Dallas, TX 75229-3169
Phone (469) 886-4700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041106000086 TX Part B Supplier - Clinic/Group Practice 8921061300 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dallas, 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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

101 Town and Country Ln
Ste 10
Hazard, KY 41701

1801 Royal Ln
Ste 810
Dallas, TX 75229
Phone (469) 886-4700

Practitioners & affiliated clinicians

Practitioners 4

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": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1609449941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 ROYAL LN STE 810",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752293169",
            "telephone_number": "469-886-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 ROYAL LN STE 810",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752293169",
            "telephone_number": "469-886-4700",
            "fax_number": "214-871-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST PATHOLOGY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-23",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "LISTON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "936-234-9557",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0007X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 26, 2024; 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.