East Texas Pathology, P.a.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

EAST TEXAS PATHOLOGY, P.A.

Practice address

3080 Milam St
Beaumont, TX 77701-4828

Phone

(409) 813-1500

Fax

(409) 813-1133

NPI assigned

Nov 15, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Peter Charles Isaac, M.D.

Title

Director

Phone

(409) 813-1500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629050893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20457",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777200457",
            "telephone_number": "409-813-1500",
            "fax_number": "409-813-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 MILAM ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014828",
            "telephone_number": "409-813-1500",
            "fax_number": "409-813-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS PATHOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ISAAC",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "409-813-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Edward Dyer III, D.D.S., M.S.D.
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• Eagle Butte Indian Health Service Hospital
• Jazmine Eaglin
• Earle S Thornhill, M.D.
• East Texas Surgical Associates, PA
• East Texas Therapy Centers, LLC
• Mary K East, LPC
• Eastex ER 2 LLC
• Eastex Sleep Solutions Inc

• All providers in Beaumont, TX
• Clinical Medical Laboratory in Texas

• 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.