Healthcare Provider Details

I. General information

NPI: 1851618276
Provider Name (Legal Business Name): JOHN PATTERSON, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2010
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11680 PEBBLE HILLS BLVD STE 107
EL PASO TX
79936-1091
US

IV. Provider business mailing address

11680 PEBBLE HILLS BLVD STE 107
EL PASO TX
79936-1091
US

V. Phone/Fax

Practice location:
  • Phone: 915-219-9434
  • Fax: 833-989-2229
Mailing address:
  • Phone: 915-262-2039
  • Fax: 833-989-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN PATTERSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 915-219-9434