Provider Demographics
NPI:1912733486
Name:PATH FORWARD PLLC
Entity type:Organization
Organization Name:PATH FORWARD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:LINH
Authorized Official - Last Name:HA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-226-3953
Mailing Address - Street 1:3101 SOUTH LAMAR BOULEVARD
Mailing Address - Street 2:#1320
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-5859
Mailing Address - Country:US
Mailing Address - Phone:512-226-3953
Mailing Address - Fax:
Practice Address - Street 1:3101 SOUTH LAMAR BOULEVARD
Practice Address - Street 2:#1320
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-5859
Practice Address - Country:US
Practice Address - Phone:512-226-3953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty