SOUTH TEXAS DERMATOPATHOLOGY LAB PA (NPI# 1265431456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265431456 |
| Entity Type | Organization |
| Organization Name | SOUTH TEXAS DERMATOPATHOLOGY LAB PA |
| Practice Address |
1122 Austin Hwy San Antonio TX 78209-4844 |
| Practice Telephone | 2103426488 |
| Practice Fax Number | 2103426725 |
| Mailing Telephone | 2103426488 |
| Mailing Fax Number | 2103426725 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2012-07-12 |
| Authorized Official Name | MR. THOMAS L DAVIS (LABORATORY DIRECTOR) |
| Authorized Official Telephone | 2103426488 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZD0900X |
Pathology Specialization: Dermatopathology |
G4960 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100245340A | 05 | |
| FL | 912055600 | 05 | |
| MN | 116882 | 05 | |
| TX | PACIFICALE | 90013183 | 01 |
| TX | 110795501 | 05 | |
| MT | 0421345 | 05 | |
| ND | 13211 | 05 | |
| TX | MEDICARE RR | 690004679 | 01 |
| Street Address |
1122 AUSTIN HWY |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78209-4844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467727750 | Mohammed Tareq Lilo | Pathology | 1122 Austin Hwy, San Antonio, TX 78209-4844 | 2012-03-20 |
| 1124312061 | Austin Pathology Associates | Dermatology | 1122 Austin Hwy, San Antonio, TX 78209-4844 | 2011-06-08 |
| 1073807137 | Patricia Kathleen Miller | Dermatology | 1122 Austin Hwy, San Antonio, TX 78209 | 2011-06-07 |
| 1366767378 | Lisa Ann Smith | Pathology | 1122 Austin Hwy, San Antonio, TX 78209-4844 | 2010-04-01 |
| 1124210059 | Juliana Robledo | Dentist | 1122 Austin Hwy, San Antonio, TX 78209-4844 | 2007-08-14 |
| 1881772283 | Maren M Chan | Pathology | 1122 Austin Hwy, San Antonio, TX 78209-4844 | 2006-11-02 |
| 1245239425 | Lester Fred Libow | Dermatology | 1122 Austin Hwy, San Antonio, TX 78209-6488 | 2005-07-19 |
| 1073512265 | Thomas Luke Davis | Pathology | 1122 Austin Hwy, San Antonio, TX 78209-4844 | 2005-07-19 |
| 1982603171 | Charles Samuel Stevens | Dermatology | 1122 Austin Hwy, San Antonio, TX 78209-4844 | 2005-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891346359 | Westlake Dermatology of San Antonio Pllc | Dermatology | 5500 Broadway Ave Ste R100, Alamo Heights, TX 78209 | 2019-09-26 |
| 1265086045 | Westlake Dermatology, Pa | Dermatology | 5500 Broadway Ave, Alamo Heights, TX 78209 | 2019-07-30 |
| 1194207530 | Arthur Davies | Licensed Vocational Nurse | 8700 Crownhill Blvd #300, San Antonio, TX 78209 | 2018-09-01 |
| 1538649462 | Jessica Michelle Moore | Licensed Vocational Nurse | 8400 Crown Hill Blvd, San Antonio, TX 78209 | 2018-08-20 |
| 1871072645 | Olawunmi Olapeju Odele | Licensed Vocational Nurse | 8700 Crownhill Blvd. Ste.300, San Antonio, TX 78209 | 2018-08-12 |
| 1265921126 | Ashley L Garcia | Physician Assistant | 414 W Sunset Rd Ste 205, San Antonio, TX 78209 | 2018-05-07 |
| 1083117428 | New Choices Treatment Center LLC | Substance Abuse Rehabilitation Facility | 3050 Eisenhauer Rd Apt 501, San Antonio, TX 78209 | 2018-03-12 |
| 1629570106 | Julieta Rubio Hobbs | Counselor | 4301 Broadway St. 438, San Antonio, TX 78209 | 2018-03-01 |
| 1326550187 | Shannon Lee Crowley | Occupational Therapy Assistant | 403 Irvington Dr, San Antonio, TX 78209 | 2017-11-01 |
| 1932627007 | Juanita De Luna Salazar | Physical Therapist | 1635 Ne Interstate 410 Loop, #600, San Antonio, TX 78209 | 2017-09-08 |
| Find all providers in zip 78209 | ||||
| Taxonomy Code | 207ZD0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Dermatopathology |
| A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source added] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. A subspecialty certificate was first issued by the ABMS in 1974. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073958906 | Olaoluwa O. Bode-omoleye | Pathology | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2013-05-06 |
| 1710217971 | Andrea Haws | Pathology | 9600 Datapoint Dr, San Antonio, TX 78229 | 2010-01-10 |
| 1336399450 | Kevin John Krauland | Pathology | 3551 Roger Brooke Dr, Dpals, San Antonio, TX 78234 | 2008-09-25 |
| 1770788457 | Margaret Abuzeid | Pathology | 9600 Datapoint Dr, San Antonio, TX 78229-2028 | 2007-06-20 |
| 1881772283 | Maren M Chan | Pathology | 1122 Austin Hwy, San Antonio, TX 78209-4844 | 2006-11-02 |
| 1073512265 | Thomas Luke Davis | Pathology | 1122 Austin Hwy, San Antonio, TX 78209-4844 | 2005-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477070886 | Mpl Inc. | Pathology | 1801 Royal Ln Ste 805, Dallas, TX 75229-7521 | 2017-08-25 |
| 1558606533 | Austin Dermpath Associates | Pathology | 3010 Williams Drive, Suite 174, Georgetown, TX 78628-2785 | 2012-12-03 |
| 1912226812 | Daniel Noland Cohen | Pathology | 2002 Holcombe Blvd Fl 3, 3b-310-suite E, Houston, TX 77030-4211 | 2010-05-18 |
| 1689716714 | Maria Clarissa Herrera | Pathology | 5327 N Central Expy Ste 300, Dallas, TX 75205-3380 | 2007-02-13 |
| 1689616450 | Candace Sue Kasper | Pathology | 2840 Keller Springs Rd, Suite 1104, Carrollton, TX 75006-4829 | 2006-06-13 |
| 1467429217 | Motaz Albahra | Pathology | 700 E Marshall, Longview, TX 75601 | 2006-03-01 |
| 1366421927 | Howard L Martin IIi | Pathology | 4131 Directors Row, Houston, TX 77092-8703 | 2006-01-12 |
| 1689662033 | Judith A Pester | Pathology | 1625 Medical Center St, El Paso, TX 79902-5005 | 2005-10-10 |
| 1326658741 | Pavandeep Gill | Pathology | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2020-08-01 |
| 1891176764 | Kelly H Hall | Pathology | 3551 Roger Brooke Dr, Mche-qd (creds), Fort Sam Houston, TX 78234-4504 | 2015-06-16 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANTONIO |
| Zip Code | 78209 |
Please comment or provide details below to improve the information on SOUTH TEXAS DERMATOPATHOLOGY LAB PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.