Provider Demographics
NPI:1154509602
Name:FITZWATER, PATRICK M (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:M
Last Name:FITZWATER
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1615 HILLENDAHL BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-3402
Mailing Address - Country:US
Mailing Address - Phone:713-462-6565
Mailing Address - Fax:713-462-6581
Practice Address - Street 1:1615 HILLENDAHL BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3402
Practice Address - Country:US
Practice Address - Phone:713-462-6565
Practice Address - Fax:713-462-6581
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2014-01-03
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Provider Licenses
StateLicense IDTaxonomies
TXPA 02759363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical