Healthcare Provider Details

I. General information

NPI: 1841649167
Provider Name (Legal Business Name): DAVID PATTERSON CO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 SPRING HILL DR 335
SPRING TX
77386-2381
US

IV. Provider business mailing address

917 W 1630 N
OREM UT
84057-8615
US

V. Phone/Fax

Practice location:
  • Phone: 281-296-8999
  • Fax: 281-296-8989
Mailing address:
  • Phone: 435-962-0524
  • Fax: 801-392-0797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberCO005620
License Number State
# 2
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberCO005620
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: