Pathnet Lab Institute South

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

COS800143 Issued in TX

Legal business name

PATHNET LAB INSTITUTE SOUTH

Practice address

2391 NE Loop 410
Marymont Business Centre Building 3 Suite 309
San Antonio, TX 78217-5600

Phone

(818) 780-6300

Fax

(818) 781-2243

NPI assigned

Apr 28, 2008

Organization subpart

Yes

Parent organization

PATHNET ESOTERIC LABORATORY INSTITUTEAs reported in NPPES

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

Authorized official

Name

Mr. Alan M Kaye

Title

President Ceo

Phone

(818) 780-6300

Specialties & licenses 1

Addresses

Other identifiers 9

Tax ID family

Pathnet Lab Institute South2 organizations share this tax ID, including this one

Part of

Pathnet Lab Institute South

Other organizations with this tax ID 1

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

• Pathnet Esoteric Laboratory Institute

  • Clinical Medical Laboratory
  • Van Nuys, CA
  • NPI 1518062082
  NPD tax ID

Locations

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1790950145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7247 HAYVENHURST AVE",
            "address_2": "SUITE A3",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914062871",
            "telephone_number": "818-780-6300",
            "fax_number": "818-781-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2391 NE LOOP 410",
            "address_2": "MARYMONT BUSINESS CENTRE BUILDING 3 SUITE 309",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175600",
            "telephone_number": "818-780-6300",
            "fax_number": "818-781-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHNET LAB INSTITUTE SOUTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATHNET ESOTERIC LABORATORY INSTITUTE",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "KAYE",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "818-780-6300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "COS800143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1670200",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OR MEDICAID",
            "identifier": "269559",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAID",
            "identifier": "37000809",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D0972921",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA MEDICAID",
            "identifier": "0589010",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD MEDICAID",
            "identifier": "404539401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112130800",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD MEDICAID",
            "identifier": "404539400",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LB233CA",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Srinivasa Reddy Pathagunti, BDS, MS, MPH
• Raja S. Pathapati, M.D.
• Rajeev Krishna Pathapati
• Pathfinder Counseling, PLLC
• Swetha Pathi
• Pathology Associates of San Antonio, L.L.P.
• Pathology Reference Laboratory, L.L.C.
• Jessica Pathrose, DO
• Pathway to Freedom Recovery Alliance LLC
• Pathways of Courage, PLLC

• Clinical Medical Laboratory in San Antonio, TX
• Providers in San Antonio, 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 Apr 28, 2008; 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.