Individual
AJAY JAYENDRA PATHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2833 W ELDORADO PKWY STE 307, LITTLE ELM, TX 75068-3540
(972) 292-0300
(972) 292-0301
Mailing address
1780 W MCDERMOTT DR STE 200, ALLEN, TX 75013-3363
(972) 954-1469
(469) 283-2743
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J6202
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115547501
—
TX
05
—
115547504
—
TX
Enumeration date
07/13/2006
Last updated
04/16/2018
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