MATTISON PATHOLOGY L.L.P. NPI 1063619922

NPI Information

  • NPI: 1063619922
  • Provider Name: MATTISON PATHOLOGY, L.L.P.
  • Classification: Pathology - 207ZP0102X
  • Specialization: Anatomic Pathology & Clinical Pathology
  • Entity Type: Organization
  • :
  • CLIA Number: 45D1015603
  • Address: 4245 N CENTRAL EXPY STE 420
    DALLAS, TX
    ZIP 75205
  • Phone: (866) 987-7284

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NPI Details

MATTISON PATHOLOGY, L.L.P. is an anatomic pathology and clinical pathology pathology in Dallas, 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 1063619922. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

4245 N CENTRAL EXPY STE 420
DALLAS, TX
ZIP 75205-566
Phone: (866) 987-7284
Fax: (469) 232-9927

The provider's authorized official is Gregory M Wolgamot .
The authorized official title is Medical Director and has the following contact phone number (866) 987-7284.

The CLIA number assigned to this NPI record is 45D1015603 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/2/2007 and was last updated on 9/8/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207ZC0500XPathologyCytopathologyNo
2291U00000XClinical Medical LaboratoryNo
3207ZP0102XPathologyAnatomic Pathology & Clinical PathologyYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
145D1065927OTHERTEXASCLIA
27187034OTHERTEXASCOLLEGE OF AMERICAN PATHOLOGISTS
345D1015603OTHERTEXASCLIA
47201511OTHERTEXASCOLLEGE OF AMERICAN PATHOLOGISTS
500Z224OTHERMEDICARE PTAN
645D1069527OTHERTEXASCLIA #

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: 11/21/2025

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