Provider Demographics
NPI:1285853416
Name:PATTON, MARY HINES (FNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:HINES
Last Name:PATTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15597 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-4100
Mailing Address - Country:US
Mailing Address - Phone:281-741-2286
Mailing Address - Fax:
Practice Address - Street 1:2120 S. WAYSIDE
Practice Address - Street 2:STE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77023-3900
Practice Address - Country:US
Practice Address - Phone:713-803-1840
Practice Address - Fax:713-938-5852
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601784363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K8325Medicare PIN