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General NPI Number Information
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NPI Number | 1821621798
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Entity Type | Individual
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Provider Name | FATIMA SHAARAN PATTERSON LMT
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Gender | Female
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 5208 AIRPORT FWY STE 167
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City | HALTOM CITY
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State | TX
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Zip | 76117-5922
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Country | US
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Telephone | 214-240-7232
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Fax |
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Provider Business Mailing Address
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Address Line | 5350 FOSSIL CREEK BLVD APT 812
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City | HALTOM CITY
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State | TX
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Zip | 76137-6236
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Country | US
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Telephone | 214-240-7232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT129314
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License Number State | TX
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