=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801314232
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PATRICK M. PADGETT HIS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2017
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2510 CROCKETT DR. STE. A
-----------------------------------------------------
City | BROWNWOOD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-646-5633
-----------------------------------------------------
Fax | 325-646-5405
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2510 CROCKETT DR STE A195
-----------------------------------------------------
City | BROWNWOOD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76801-5928
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-646-5633
-----------------------------------------------------
Fax | 325-646-5405
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237700000X
-----------------------------------------------------
Taxonomy Name | Hearing Instrument Specialist
-----------------------------------------------------
License Number | 50239
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------