MEDICARE: DR. PATRICK M. LADAGE OD, PHD

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	152W00000X	Optometrist	7033TG	TX

General Provider Information

NPI Number	:	1205958501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK M. LADAGE OD, PHD

Provider Business Mailing Address
First Line	:	2906 ABBEY FIELD DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-8684
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16200 CITY WALK
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-6543
Country	:	US
Telephone Number	:	281-265-2000
Fax Number	:

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

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	07/08/2007

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