Healthcare Provider Details

I. General information

NPI: 1295845493
Provider Name (Legal Business Name): PATRICIA M FERRIE LSA/CST/CFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 SAINT ALBENS PL
GARLAND TX
75040-1144
US

IV. Provider business mailing address

PO BOX 117
ROWLETT TX
75030-0117
US

V. Phone/Fax

Practice location:
  • Phone: 972-986-3030
  • Fax: 972-986-9820
Mailing address:
  • Phone: 972-986-3030
  • Fax: 972-986-9820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License NumberSA00068
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License NumberSA00068
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: