Healthcare Provider Details

I. General information

NPI: 1730113754
Provider Name (Legal Business Name): HANOCH AVRAHAM PATT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4314 MEDICAL PKWY SUITE 200
AUSTIN TX
78756-3334
US

IV. Provider business mailing address

4314 MEDICAL PKWY SUITE 200
AUSTIN TX
78756-3334
US

V. Phone/Fax

Practice location:
  • Phone: 512-454-1110
  • Fax: 512-374-1354
Mailing address:
  • Phone: 512-454-1110
  • Fax: 512-374-1354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberM2009
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: