Healthcare Provider Details

I. General information

NPI: 1609858232
Provider Name (Legal Business Name): MORRIS K PATTESON JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 PRIVATE ROAD 4060
LAMPASAS TX
76550-4071
US

IV. Provider business mailing address

207 W AVENUE E
LAMPASAS TX
76550-1820
US

V. Phone/Fax

Practice location:
  • Phone: 512-556-3621
  • Fax: 512-556-6594
Mailing address:
  • Phone: 512-556-3621
  • Fax: 512-556-6594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE2779
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: