NPIMap

Organization Active NPI

Pathologists Bio-Medical Laboratories PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Waxahachie, TX
National Provider Identifier
1982900460
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PATHOLOGISTS BIO-MEDICAL LABORATORIES PLLC
Practice address
1405 W Jefferson St
Waxahachie, TX 75165-2231
Phone
(972) 935-9095
NPI assigned
Feb 1, 2011
Last updated
Sep 13, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PATHOLOGISTS BIO-MEDICAL LABORATORIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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) 818-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

1405 W Jefferson St
Waxahachie, TX 75165-2231

Mailing address

3600 Gaston Ave
Wadley Tower, Suite 261
Dallas, TX 75246-1800
Phone (214) 818-9100

Other names 2

  • Pathologists Bio-Medical Laboratories LLP Former legal business name
  • PBM REST OF TEXAS Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041112001162 TX Part B Supplier - Clinic/Group Practice 7911961677 Receives reassigned benefits from 68 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: McKinney, TX; Plano, TX; Pittsburg, TX; Quitman, TX; Southlake, TX; Trophy Club, TX; Tyler, TX; Victoria, TX…

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
George J Netto MD5 organizations share this tax ID, including this one
Part of
George J Netto MD

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568332800000",
    "number": "1982900460",
    "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": "1405 W JEFFERSON ST",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751652231",
            "telephone_number": "972-935-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGISTS BIO-MEDICAL LABORATORIES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATHOLOGISTS BIO-MEDICAL LABORATORIES",
        "enumeration_date": "2011-02-01",
        "last_updated": "2019-09-13",
        "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": "214-818-9100",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathologists Bio-Medical Laboratories LLP",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "PBM REST OF TEXAS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PBM REST OF TEXAS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waxahachie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; 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.