MEDICARE: PATRICK WARREN HISEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	L2939	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144228578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK WARREN HISEL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2333
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-7333
Country	:	US
Telephone Number	:	940-325-6831
Fax Number	:	940-325-6891

Provider Business Practice Location Address
First Line	:	750 EUREKA ST STE B
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-6521
Country	:	US
Telephone Number	:	940-325-6831
Fax Number	:	940-325-6891

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2005
Last Update Date	:	09/11/2023

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