MEDICARE: CHRISTIAN PATTERSON

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	225X00000X	Occupational Therapist	117722	TX

General Provider Information

NPI Number	:	1568163707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN PATTERSON

Provider Business Mailing Address
First Line	:	15414 RIVER BND
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-2917
Country	:	US
Telephone Number	:	210-478-0548
Fax Number	:

Provider Business Practice Location Address
First Line	:	15414 RIVER BND
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-2917
Country	:	US
Telephone Number	:	210-478-0548
Fax Number	:

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

Provider Enumeration Date	:	03/14/2023
Last Update Date	:	03/14/2023

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Directions to “ CHRISTIAN PATTERSON ” Practice Location

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