Provider Demographics
NPI:1417231622
Name:P.A.T.H. 2 WELLNESS
Entity Type:Organization
Organization Name:P.A.T.H. 2 WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-280-1939
Mailing Address - Street 1:4306 CANADIANA LN
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-9448
Mailing Address - Country:US
Mailing Address - Phone:956-280-1939
Mailing Address - Fax:
Practice Address - Street 1:504 E 2ND ST
Practice Address - Street 2:SUITE B
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-3810
Practice Address - Country:US
Practice Address - Phone:956-280-1939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service