Provider Demographics
NPI:1295179836
Name:PATTERSON, ASHLEY M (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:M
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2255 E MOSSY OAKS RD STE 480
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-1813
Mailing Address - Country:US
Mailing Address - Phone:954-263-1424
Mailing Address - Fax:
Practice Address - Street 1:2255 E MOSSY OAKS RD STE 480
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-1813
Practice Address - Country:US
Practice Address - Phone:954-263-1424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS2457208000000X
FLME 126576208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017407000Medicaid