Organization
ATHENA HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MARCIANO DPM (PRESIDENT)
(817) 915-3557
Entity
Organization
Contact information
Practice address
1940 E STATE HIGHWAY 114 STE 150, SOUTHLAKE, TX 76092-6526
(817) 424-3668
(817) 442-8637
Mailing address
1940 E STATE HIGHWAY 114 STE 150, SOUTHLAKE, TX 76092-6526
(817) 424-3668
(817) 442-8637
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
2083S0010X
Sports Medicine (Preventive Medicine) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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