Provider Demographics
NPI:1659124311
Name:PATHWAYS PHYSICIANS TEXAS, PLLC
Entity Type:Organization
Organization Name:PATHWAYS PHYSICIANS TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMUNDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-688-6330
Mailing Address - Street 1:3001 KNOX ST STE 303
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-7304
Mailing Address - Country:US
Mailing Address - Phone:972-688-6330
Mailing Address - Fax:
Practice Address - Street 1:3001 KNOX ST STE 303
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-7304
Practice Address - Country:US
Practice Address - Phone:972-688-6330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty