Provider Demographics
NPI:1851838387
Name:PATMOS CONSULTING LLC
Entity Type:Organization
Organization Name:PATMOS CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PIC
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MULVANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-487-4045
Mailing Address - Street 1:1432 GRAPEVINE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-3698
Mailing Address - Country:US
Mailing Address - Phone:469-487-4045
Mailing Address - Fax:
Practice Address - Street 1:5445 LA SIERRA DR STE 202
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4176
Practice Address - Country:US
Practice Address - Phone:469-267-7762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX312053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2166016OtherPK