MEDICARE: MICHELLE PATA NP

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	363L00000X	Nurse Practitioner	TEMPORARY	TX

General Provider Information

NPI Number	:	1427545151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE PATA NP

Provider Business Mailing Address
First Line	:	20320 NORTHWEST FWY STE 900
Second Line	:
City	:	JERSEY VILLAGE
State	:	TX
Zip	:	77065-5620
Country	:	US
Telephone Number	:	281-453-7232
Fax Number	:	281-440-2020

Provider Business Practice Location Address
First Line	:	3550 RAYFORD RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-4343
Country	:	US
Telephone Number	:	281-586-3888
Fax Number	:	281-440-2020

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

Provider Enumeration Date	:	04/18/2018
Last Update Date	:	04/18/2018

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Directions to “ MICHELLE PATA NP” Practice Location

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