Organization Active NPI

Ameripath Lubbock 5.01(a) Corporation

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Worth, TX
National Provider Identifier
1700860434
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
45D0701182 Issued in TX
Legal business name
AMERIPATH LUBBOCK 5.01(A) CORPORATION
Practice address
1401 Pennsylvania Ave
Fort Worth, TX 76104-2113
Phone
(713) 432-1100
Fax
(713) 432-0221
NPI assigned
Dec 6, 2005
Organization subpart
Yes
Parent organization
AMERIPATH INC.As reported in NPPES

Authorized official

NPPES NPI Registry
Name
Darren Thomas Wheeler
Title
Vice President
Phone
(702) 733-7866

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Member of 1

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

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000711 TX Part B Supplier - Clinic/Group Practice 5890690085 Receives reassigned benefits from 19 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cleburne, TX; Plainview, TX; Lubbock, TX; Fort Worth, TX; Azle, TX; Arlington, TX

National Provider Directory

National Provider Directory
Tax ID family
Ameripath Lubbock 501a Corporation7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1301 Pennsylvania Ave
Fl 4
Ft Worth, TX 76104
Phone (682) 236-7805

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 45D0701182 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

1401 Pennsylvania Ave
Fort Worth, TX 76104-2113

Mailing address

4770 Regent Blvd
Irving, TX 75063-2445

Other practice location 1

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 250-5600

Other practice location 2

10864 Texas Health Trl
Fort Worth, TX 76244-4897
Phone (682) 212-2100

Other practice location 3

108 Denver Trl
Azle, TX 76020-3614
Phone (817) 444-8630

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
45D0914073OtherTXCLIA

Other names 1

NPPES NPI Registry
  • Pathology Associates of Texas Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 3, 2026.

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785715200000",
    "number": "1700860434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 REGENT BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042113",
            "telephone_number": "713-432-1100",
            "fax_number": "713-432-0221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761042122",
            "country_code": "US",
            "telephone_number": "817-250-5600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10864 Texas Health Trl",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "762444897",
            "country_code": "US",
            "telephone_number": "682-212-2100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 Denver Trl",
            "address_purpose": "LOCATION",
            "city": "Azle",
            "state": "TX",
            "postal_code": "760203614",
            "country_code": "US",
            "telephone_number": "817-444-8630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AMERIPATH LUBBOCK 5.01(A) CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERIPATH INC.",
        "enumeration_date": "2005-12-06",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "702-733-7866"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "45D0701182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D0914073",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathology Associates of Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; 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.