Avero Diagnostics
LBN: Mattison Pathology, L.L.P.
Avero Diagnostics is an health care organization with primary practice located at 4642 N Loop 289 Ste 205 , Lubbock TX 79416-2424. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cytopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine, Laboratories / Clinical Medical Laboratory. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is the primary health care specialty.
Mattison Pathology, L.L.P. can be contacted via phone (360) 543-6836, or through Wolgamot, Gregory M via phone (806) 687-7284.
Contact Information
Primary practice address
4642 N Loop 289 Ste 205
Lubbock TX 79416-2424
Phone: (360) 543-6836
Fax: (971) 402-0065
Website:
Authorized official contact:
Name: Wolgamot, Gregory M Doctor of Medicine (MD)
Phone: (806) 687-7284
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cytopathology | 207ZC0500X | ||
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | ||
| Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine | 207ZP0105X | ||
| Laboratories / Clinical Medical Laboratory | 291U00000X | 45D1015603 | Texas |
Profile Details
| NPI number | 1093820763 |
|---|---|
| LBN Legal business name | Mattison Pathology, L.L.P. |
| DBA Doing business as | Avero Diagnostics |
| Authorized official | Wolgamot, Gregory M Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 20th, 2006 |
| Last updated | Apr 4th, 2024 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093820763 | NPPES |
| Arkansas | MEDICAID | 177874709 | |
| Arkansas | Other | 45D1069527 | |
| Arkansas | Other | L166 | |
| Arkansas | Other | 45D1015603 | |
| Arkansas | MEDICAID | 72922010 | |
| Arkansas | Other | 7187034 | |
| Arkansas | Other | 7201511 | |
| Arkansas | Other | 0075KP | |
| Arkansas | MEDICAID | 1646044-01 |
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