DR. MARY E EBERLE (NPI# 1730169236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730169236 |
| Entity Type | Individual |
| Full Name | DR. MARY E EBERLE |
| Credential | MD |
| Practice Address |
3615 19th St Lubbock TX 79410-1203 |
| Mailing Address |
14275 Midway Rd Suite 400 Addison TX 75001-3614 |
| Practice Telephone | 8067441887 |
| Practice Fax Number | 8067445545 |
| Mailing Telephone | 8067254271 |
| Mailing Fax Number | 6102714245 |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2017-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
F3920 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 042641301 | 05 | |
| TX | BCBS | 83P804 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205265170 | Mary C Eberle | Social Worker | 540 Water St Ste 202, Ketchikan, AK 99901-6378 | 2013-11-01 |
| 1568063428 | Mary J Eberle | Pharmacist | 2071 N Main St, Canton, IL 61520-1032 | 2020-11-05 |
| 1154705002 | Mary C Eberle | Social Worker | 1116 N 16th St, Lafayette, IN 47904-2119 | 2015-07-09 |
| Street Address |
3615 19TH ST |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79410-1203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144217100 | Thelma Wong Sutter | Specialist | 3615 19th St, Lubbock, TX 79410-1203 | 2005-10-04 |
| 1831798685 | Jacob Don Paul | Nurse Practitioner | 3615 19th St, Lubbock, TX 79410-1203 | 2020-10-22 |
| 1336778711 | Ephraim Joseph Anderson | Religious Nonmedical Practitioner | 3615 19th St, Lubbock, TX 79410-1203 | 2020-04-07 |
| 1275188229 | Emily White | Registered Nurse | 3615 19th St, Lubbock, TX 79410-1203 | 2019-08-06 |
| 1811456569 | Melinda Dixon | Nurse Practitioner | 3615 19th St, Lubbock, TX 79410-1209 | 2019-03-12 |
| 1134693880 | Alexandra D Bates | Nurse Practitioner | 3615 19th St, Lubbock, TX 79410-1203 | 2019-01-16 |
| 1790256915 | Alyssa Taylor | Pharmacist | 3615 19th St, Lubbock, TX 79410-1209 | 2018-12-16 |
| 1346723517 | Matthew E Heers | Physical Therapy Assistant | 3615 19th St, Lubbock, TX 79410-1203 | 2018-09-12 |
| 1417468992 | Tyler Little | Physician Assistant | 3615 19th St, Lubbock, TX 79410-1203 | 2017-10-23 |
| 1598294712 | David Marsh | Emergency Medicine | 3615 19th St, Lubbock, TX 79410-1203 | 2017-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548878267 | Covenant Medical Center | Clinic/Center | 3615 19th, Lifestyle Centre-east Parking Garage, Lubbock, TX 79410 | 2020-07-20 |
| 1669038626 | Hub City Anesthesia | Nurse Anesthetist, Certified Registered | 3416 22nd Street, Lubbock, TX 79410 | 2019-05-15 |
| 1912447418 | Lubbock Surgery Center, LLC | Clinic/Center | 3416 22nd St, Lubbock, TX 79410 | 2017-03-02 |
| 1871032698 | Lezlee Berry | Pharmacist | 3615 19th Street, Lubbock, TX 79410 | 2017-02-13 |
| 1376914101 | Matthew Cotton | Nurse Practitioner | 2424 Quaker Ave, Lubbock, TX 79410 | 2015-10-20 |
| 1841534864 | Frank Nwabugwu | Pharmacist | 4120 34th Street, Lubbock, TX 79410 | 2012-11-15 |
| 1689954794 | Dharmendra Kumar | Pediatrics | Covenant Children's Hospital, 4000 24th Street, Lubbock, TX 79410 | 2011-08-19 |
| 1518277177 | T.r.m. Rao, M.d., P.a. | Colon & Rectal Surgery | 3809 22nd Street, Suite C, Lubbock, TX 79410 | 2010-10-18 |
| 1700196672 | Hanford Consultations P.a. | Family Medicine | 4000 22nd Place Suite 100, Lubbock, TX 79410 | 2010-10-13 |
| 1336452598 | Amanda Collins | Specialist | 4801 34th Street, Lubbock, TX 79410 | 2010-07-16 |
| Find all providers in zip 79410 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700080595 | Irfan Warraich | Pathology | Texas Tech Health Sciences Ctr, 3601 4th Street, Lubbock, TX 79430-0001 | 2007-06-13 |
| 1023102043 | Ameripath Lubbock 5.01(a) Corporation | Pathology | 4920 S Loop 289, Suite 101, Lubbock, TX 79414-4797 | 2006-10-03 |
| 1841346525 | Rodney Wade Stuart | Pathology | 410 N Utica Ave, Lubbock, TX 79416-3035 | 2007-01-26 |
| 1942383724 | Ann R Eastman | Pathology | 410 N Utica Ave, Lubbock, TX 79416-3035 | 2006-10-23 |
| 1396831772 | Jason Travis Loos | Pathology | 3615 19th St, Lubbock, TX 79410-1203 | 2006-10-05 |
| 1952411977 | Michael Trae Mattison | Pathology | 410 N Utica Ave, Lubbock, TX 79416-3035 | 2006-08-30 |
| 1174633150 | Thomas Randolph Mattison | Pathology | 410 N Utica Ave, Lubbock, TX 79416-3035 | 2006-08-30 |
| 1134190705 | Ameripath Lubbock 501a Corporation | Pathology | 3615 19th St, Lubbock, TX 79410-1203 | 2006-01-31 |
| 1760462279 | Ashraf M Khan | Pathology | 3615 19th St, Lubbock, TX 79410-1203 | 2006-01-19 |
| 1437139946 | Jose E Pinto | Pathology | 3615 19th St, Lubbock, TX 79410-1203 | 2006-01-19 |
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| 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.