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General NPI Number Information
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NPI Number | 1225395015
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Entity Type | Organization
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Legal Business Name | AJAY J PATHAK, MD PA
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 07/09/2020
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Provider Practice Location Address
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Address Line | 5899 PRESTON RD STE 1002
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City | FRISCO
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State | TX
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Zip | 75034-9593
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Country | US
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Telephone | 972-378-0066
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Fax | 972-378-3222
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Provider Business Mailing Address
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Address Line | 5899 PRESTON RD STE 1002
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City | FRISCO
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State | TX
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Zip | 75034-9593
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Country | US
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Telephone | 972-378-0066
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Fax | 972-378-3222
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Authorized Official
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Title or Position | OWNER
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Name | AJAY PATHAK
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Credential | MD
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Telephone | 972-533-2280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | J6202
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License Number State | TX
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