Healthcare Provider Details

I. General information

NPI: 1093944225
Provider Name (Legal Business Name): PATRICIA C NELSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA C BUTTKE M.D.

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 TRANS MOUNTAIN RD FL 3B
EL PASO TX
79911-3601
US

IV. Provider business mailing address

2000B TRANS MOUNTAIN RD FL 3
EL PASO TX
79911-3600
US

V. Phone/Fax

Practice location:
  • Phone: 915-215-8400
  • Fax: 915-612-9253
Mailing address:
  • Phone: 915-215-8400
  • Fax: 915-612-9253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101248659
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberR1596
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: