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NPI Code Detail

MEDICARE: DR. PATRICK THOMAS NOONAN JR. M.D.

MEDICARE: DR. PATRICK THOMAS NOONAN JR. M.D.
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
12085N0700XNeuroradiology PhysicianD55507MD
22085N0700XNeuroradiology PhysicianN8231TX
32085N0700XNeuroradiology Physician4301087793MI

General Provider Information

NPI Number : 1942250204
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICK THOMAS NOONAN JR. M.D.
Provider Business Mailing Address
First Line : PO BOX 749
Second Line :
City : PHARR
State : TX
Zip : 78577-1614
Country : US
Telephone Number : 956-362-2171
Fax Number :
Provider Business Practice Location Address
First Line : 5501 S MCCOLL RD
Second Line :
City : EDINBURG
State : TX
Zip : 78539-5503
Country : US
Telephone Number : 956-362-8677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 01/19/2017

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