Provider Demographics
NPI:1235298449
Name:PATINO, JILL L
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:L
Last Name:PATINO
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 1:8905 MOUNTBATTEN CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-3021
Mailing Address - Country:US
Mailing Address - Phone:512-231-0702
Mailing Address - Fax:
Practice Address - Street 1:504 N 10TH ST STE B4
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4578
Practice Address - Country:US
Practice Address - Phone:956-668-0707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies