MEDICARE: MS. PATRICIA ANN REMICK PNP

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	363LP0200X	Pediatric Nurse Practitioner	242199	TX

General Provider Information

NPI Number	:	1184855363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA ANN REMICK PNP

Provider Business Mailing Address
First Line	:	4499 MEDICAL DR STE 311
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3713
Country	:	US
Telephone Number	:	210-615-8757
Fax Number	:	210-615-8789

Provider Business Practice Location Address
First Line	:	4499 MEDICAL DR STE 311
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3713
Country	:	US
Telephone Number	:	210-615-8757
Fax Number	:	210-615-8789

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

Provider Enumeration Date	:	08/05/2009
Last Update Date	:	08/05/2009

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