Provider Demographics
NPI:1003812785
Name:HIGDON, PATRICK B (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:B
Last Name:HIGDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 MORGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2025
Mailing Address - Country:US
Mailing Address - Phone:210-762-3662
Mailing Address - Fax:361-730-2172
Practice Address - Street 1:805 MORGAN AVE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2025
Practice Address - Country:US
Practice Address - Phone:210-762-3662
Practice Address - Fax:361-730-2172
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056188207Q00000X, 208M00000X
TXT8836208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA080180925OtherRR MEDICARE
VA5630592Medicaid
VA291974OtherANTHEM
VA291974OtherANTHEM
VA5630592Medicaid