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General NPI Number Information
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NPI Number | 1962685198
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Entity Type | Organization
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Legal Business Name | PATHWAYS AUTISM CENTER
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 837 E ESPERANZA AVE SUITE B
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City | MCALLEN
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State | TX
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Zip | 78501-1454
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Country | US
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Telephone | 956-664-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 837 E ESPERANZA AVE SUITE B
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City | MCALLEN
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State | TX
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Zip | 78501-1454
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Country | US
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Telephone | 956-664-2800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRUDI DIANE PACHECO
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Credential | LOT
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Telephone | 956-664-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 102303
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 104062
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License Number State | TX
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