Provider Demographics
NPI:1053643890
Name:PATTERSON, JOSHUA (PA)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 NORTHRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-0826
Mailing Address - Country:US
Mailing Address - Phone:214-493-3303
Mailing Address - Fax:
Practice Address - Street 1:5401 LONG PRAIRIE RD STE 100
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2212
Practice Address - Country:US
Practice Address - Phone:972-691-9190
Practice Address - Fax:972-691-3841
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06622363A00000X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX313653301Medicaid
TX269725YKN5Medicare PIN