PBM Pathology Services PLLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

45D0481682 Issued in TX

Legal business name

PBM PATHOLOGY SERVICES PLLC

Practice address

1111 Northpoint Dr
Coppell, TX 75019-3831

Phone

(972) 966-7830

NPI assigned

Jul 15, 2013

Organization subpart

No

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

Authorized official

Name

Peter A Dysert II, M.D.NPI 1619903226

Title

President

Phone

(214) 823-6492

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Peter Allen Dysert, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Dallas, TX
  • NPI 1619903226
  NPD Authorized official

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1730520198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "WADLEY TOWER, SUITE 261",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461800",
            "telephone_number": "214-818-9100",
            "fax_number": "214-818-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 NORTHPOINT DR",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750193831",
            "telephone_number": "972-966-7830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 S State Highway 121 Bus",
            "address_2": "SUITE 1210",
            "address_purpose": "LOCATION",
            "city": "Lewisville",
            "state": "TX",
            "postal_code": "750674394",
            "country_code": "US",
            "telephone_number": "214-818-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PBM PATHOLOGY SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-15",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "DYSERT",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-823-6492",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D0481682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Marie Patterson, RDH
• Allyson M Pattison, PT, DPT
• Ashley Camille Pattison, SLP
• Allison Ozarowski Paul, DC
• Leland Paul
• Mercy Pearce, PA-C
• Peculiar Healthcare Services
• Grace Kirsten Pelletier
• Jared Pels, O.D.
• Kevin Pels

• Clinical Medical Laboratory in Coppell, TX
• Providers in Coppell, 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 Sep 6, 2023; 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.