Individual
ATHENA TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3126 W FM 120, DENISON, TX 75020-1249
(903) 416-7544
(903) 416-7545
Mailing address
5012 S US HWY 75, SUITE 300, ATTN BILLING, DENISON, TX 75020-4587
(903) 416-6460
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2869
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/18/2017
Last updated
08/21/2020
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