Provider Demographics
NPI:1114520400
Name:HALBROOK, PATRICIA LANEE
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LANEE
Last Name:HALBROOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8611 NAOMI ST
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7804
Mailing Address - Country:US
Mailing Address - Phone:501-410-4448
Mailing Address - Fax:
Practice Address - Street 1:6124 W PARKER RD STE 134
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8124
Practice Address - Country:US
Practice Address - Phone:972-981-7777
Practice Address - Fax:972-981-7761
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144839363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily