Premier Pathology Lab, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PREMIER PATHOLOGY LAB, LLC

Practice address

230 Ed English Dr Unit D
Shenandoah, TX 77385-8744

Phone

(936) 231-8027

Fax

(281) 476-7798

NPI assigned

Sep 4, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Thinh Phan, M.D.

Title

Owner

Phone

(888) 416-8118

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1700286135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19073 NORTH I-45 FWY STE 145",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773858744",
            "telephone_number": "936-231-8027",
            "fax_number": "281-476-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 ED ENGLISH DR UNIT D",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773858744",
            "telephone_number": "936-231-8027",
            "fax_number": "281-476-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PATHOLOGY LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-04",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "THINH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-416-8118",
        "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": []
}

• Angel M Porter, RN
• Lauren Casey Pradilla, PT, DPT
• Sameer Prakash, D.O.
• Premier General and Colorectal Surgery, PA
• Premier Genomics LLC
• Procura Pain and Spine, PLLC
• James Craig Puett, MS, OTR, CHT
• Michelle Pulpan, NP
• Anisha Pumphrey, CCMA, DOULA
• John Michael Punla

• Clinical Medical Laboratory in Shenandoah, TX
• Providers in Shenandoah, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.