Healthcare Provider Details
I. General information
NPI: 1548079387
Provider Name (Legal Business Name): PATCHES WEST LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/06/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7830 W GRAND PKWY S STE 150
RICHMOND TX
77406-5819
US
IV. Provider business mailing address
7830 W GRAND PKWY S STE 150
RICHMOND TX
77406-5819
US
V. Phone/Fax
- Phone: 346-826-0800
- Fax:
- Phone: 346-826-0800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RILEY
ORR
Title or Position: COO
Credential:
Phone: 615-314-1406