MEDICARE: PATCHES WEST LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1548079387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATCHES WEST LLC

Provider Business Mailing Address
First Line	:	7830 W GRAND PKWY S STE 150
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-5819
Country	:	US
Telephone Number	:	346-826-0800
Fax Number	:

Provider Business Practice Location Address
First Line	:	7830 W GRAND PKWY S STE 150
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-5819
Country	:	US
Telephone Number	:	346-826-0800
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	RILEY ORR
Credential	:
Telephone Number	:	615-314-1406

Provider Enumeration Date	:	01/06/2025
Last Update Date	:	12/16/2025

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Directions to “PATCHES WEST LLC ” Practice Location

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