Provider Demographics
NPI:1790243103
Name:ALPHA ORTHOPEDIC PHYSICIAN GROUP, P.A.
Entity Type:Organization
Organization Name:ALPHA ORTHOPEDIC PHYSICIAN GROUP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAWLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-838-1635
Mailing Address - Street 1:6850 TPC DR STE 116
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3145
Mailing Address - Country:US
Mailing Address - Phone:972-838-1635
Mailing Address - Fax:
Practice Address - Street 1:204 MEDICAL DRIVE
Practice Address - Street 2:SUITE 110
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092
Practice Address - Country:US
Practice Address - Phone:972-838-1635
Practice Address - Fax:972-838-1634
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALPHA ORTHOPEDIC PHYSICIAN GROUP, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty