Provider Demographics
NPI:1174109979
Name:R IRVIN MORGAN MD PA PATHOLOGY ASSOCIATES
Entity type:Organization
Organization Name:R IRVIN MORGAN MD PA PATHOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOUSHIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:EBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:903-455-4051
Mailing Address - Street 1:4818 WELLINGTON ST STE 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-6010
Mailing Address - Country:US
Mailing Address - Phone:903-455-4051
Mailing Address - Fax:903-454-1716
Practice Address - Street 1:4818 WELLINGTON ST STE 4
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-6010
Practice Address - Country:US
Practice Address - Phone:903-455-4051
Practice Address - Fax:903-454-1716
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:R IRVIN MORGAN MD PA PATHOLOGY ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-22
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory