Provider Demographics
NPI:1790558229
Name:PATHFINDER MEDICAL CONSULTING, LLC
Entity Type:Organization
Organization Name:PATHFINDER MEDICAL CONSULTING, LLC
Other - Org Name:MEDX GENETIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEVERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-209-8658
Mailing Address - Street 1:4432 E 90TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-2713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13601 W MEMORIAL PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8355
Practice Address - Country:US
Practice Address - Phone:405-862-7850
Practice Address - Fax:844-682-1330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGeneticsGroup - Single Specialty