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General NPI Number Information
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NPI Number | 1760326060
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Entity Type | Organization
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Legal Business Name | PUREPATH MD
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 325 W ST PAUL ST SUITE 3100
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City | DALLAS
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State | TX
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Zip | 75201
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Country | US
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Telephone | 469-513-4017
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Fax |
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Provider Business Mailing Address
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Address Line | 325 W ST PAUL ST SUITE 3100
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City | DALLAS
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State | TX
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Zip | 75201
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Country | US
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Telephone | 469-513-4017
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Fax |
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Authorized Official
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Title or Position | CAO
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Name | KASEY ROBERTSON
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Credential | CHIEF ADMIN OFFICER
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Telephone | 210-422-4613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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