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MATTISON PATHOLOGY L.L.P. NPI 1093820763


NPI Information

NPI: 1093820763
Provider Name: MATTISON PATHOLOGY, L.L.P.

Doing Business As: AVERO DIAGNOSTICS

Classification: Pathology - 207ZP0102X
Entity Type: Organization

Specialization: Anatomic Pathology & Clinical Pathology

Address:
4642 N LOOP 289 STE 205
LUBBOCK, TX
ZIP 79416
Phone: (360) 543-6836
Get Directions

MATTISON PATHOLOGY, L.L.P. is an anatomic pathology and clinical pathology pathology in Lubbock, TX. The provider is 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. MATTISON PATHOLOGY, L.L.P. NPI is 1093820763. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Avero Diagnostics.

The provider's business location address is:

4642 N LOOP 289 STE 205
LUBBOCK, TX
ZIP 79416-424
Phone: (360) 543-6836
Fax: (971) 402-0065

The provider's authorized official is Gregory M Wolgamot .
The authorized official title is M.d. and has the following contact phone number (806) 687-7284.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 4/4/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ZC0500XPathologyCytopathologyNo
2207ZP0102XPathologyAnatomic Pathology & Clinical PathologyYes
3207ZP0105XPathologyClinical Pathology/Laboratory MedicineNo
4291U00000XClinical Medical Laboratory45D1015603TEXASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1177874709MEDICAIDARKANSAS
245D1069527OTHERTEXASCLIA
3L166OTHERTEXASFIRSTCARE
445D1015603OTHERTEXASCLIA
572922010MEDICAIDNEW MEXICO
67187034OTHERTEXASCOLLEGE OF AMERICAN PATHOLOGISTS
77201511OTHERTEXASCOLLEGE OF AMERICAN PATHOLOGISTS
80075KPOTHERTEXASBLUE CROSS BLUE SHIELD
91646044-01MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.