NPIMap

Organization Active NPI

East Texas Medical Center Healthcare Associates

  • Pathology Specialist/Technologist
  • Tyler, TX
National Provider Identifier
1619917481
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pathology Specialist/TechnologistTaxonomy code 246Q00000X
Legal business name
EAST TEXAS MEDICAL CENTER HEALTHCARE ASSOCIATES
Practice address
904 S Beckham Ave
Tyler, TX 75701-1906
Phone
(903) 596-3555
Fax
(903) 596-3560
NPI assigned
Jun 8, 2006
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
Ms. Kim Pearson-Wahl
Title
Vice President
Phone
(903) 535-6898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pathology Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246Q00000X Primary

Addresses

Primary practice location

904 S Beckham Ave
Tyler, TX 75701-1906

Mailing address

PO Box 131027
Tyler, TX 75713-1027

Other names 1

  • East Texas Pathology Services Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619917481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 131027",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757131027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011906",
            "telephone_number": "903-596-3555",
            "fax_number": "903-596-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS MEDICAL CENTER HEALTHCARE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEARSON-WAHL",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "903-535-6898",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "246Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Texas Pathology Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyler, 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.