Provider Demographics
NPI:1962481820
Name:PROPATH SERVICES, LLC
Entity type:Organization
Organization Name:PROPATH SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-237-1664
Mailing Address - Street 1:1355 RIVER BEND DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4915
Mailing Address - Country:US
Mailing Address - Phone:214-638-2000
Mailing Address - Fax:214-631-6724
Practice Address - Street 1:1355 RIVER BEND DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4915
Practice Address - Country:US
Practice Address - Phone:214-638-2000
Practice Address - Fax:214-631-6724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D0908676291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135253605Medicaid
TX135253604Medicaid
TX135253603Medicaid
TX135253606Medicaid
TX161576701Medicaid
TX135253602Medicaid
TX135253607Medicaid
TXCL8536Medicare PIN
TXCL8654Medicare PIN
TXCL8217Medicare PIN
CL8444Medicare PIN
TXCL8437Medicare PIN
TXCL8474Medicare PIN
CL8445Medicare PIN
TXCL8438Medicare PIN