MEDICARE: MR. PATRICK SHAWN WALSH PA

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1366764797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PATRICK SHAWN WALSH PA

Provider Business Mailing Address
First Line	:	714 PAINTBRUSH DR
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-8041
Country	:	US
Telephone Number	:	210-569-9582
Fax Number	:

Provider Business Practice Location Address
First Line	:	36000 DARNALL LOOP
Second Line	:	CARL R. DARNALL ARMY MEDICAL CENTER
City	:	FORT HOOD
State	:	TX
Zip	:	76544-0000
Country	:	US
Telephone Number	:	254-288-8025
Fax Number	:

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

Provider Enumeration Date	:	02/26/2010
Last Update Date	:	02/26/2010

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