Healthcare Provider Details

I. General information

NPI: 1205813854
Provider Name (Legal Business Name): THOMAS J PATTON JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2005
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 S CONROE MEDICAL DR
CONROE TX
77304-4722
US

IV. Provider business mailing address

605 S CONROE MEDICAL DR
CONROE TX
77304-4722
US

V. Phone/Fax

Practice location:
  • Phone: 936-539-4004
  • Fax: 936-521-3964
Mailing address:
  • Phone: 936-539-4004
  • Fax: 936-539-3635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberF7033
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberME79208
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberF7033
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: