Provider Demographics
NPI:1740675297
Name:APOLLO PATH, LLC
Entity type:Organization
Organization Name:APOLLO PATH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILCHGRUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-871-8616
Mailing Address - Street 1:3824 CEDAR SPRINGS RD
Mailing Address - Street 2:BOX 110
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4136
Mailing Address - Country:US
Mailing Address - Phone:972-685-0870
Mailing Address - Fax:214-871-8647
Practice Address - Street 1:1890 CROWN DR
Practice Address - Street 2:SUITE 1330
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-9437
Practice Address - Country:US
Practice Address - Phone:972-685-0870
Practice Address - Fax:214-871-8647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-01
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory