PBM Pathology Services PLLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PBM PATHOLOGY SERVICES PLLC

Practice address

2709 N Ben Wilson St
Victoria, TX 77901-5728

Phone

(361) 575-1111

NPI assigned

Dec 3, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Peter Allen DysertNPI 1619903226

Title

Managing Partner

Phone

(214) 818-9122

Specialties & licenses 1

Addresses

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": "1606953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1871198028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE STE 261",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461902",
            "telephone_number": "972-966-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 N BEN WILSON ST",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015728",
            "telephone_number": "361-575-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PBM PATHOLOGY SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "DYSERT",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "214-818-9122",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Narender Pati, R.PH.
• Paul E Mondolfi, MD, PA
• Kelly M Paulk, M.A., L.P.C
• Holly Pavlicek
• Vanessa Vanover Payne, APRN, FNP-C
• Perez Orthopedics, PLLC
• Krystal Perez, CCC-SLP
• Maria Elissa Perez, RDH
• Michael Perez, M.D.
• Samantha Perez, LPC

• Clinical Medical Laboratory in Victoria, TX
• Providers in Victoria, 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 Dec 3, 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.