Provider Demographics
NPI:1295845493
Name:FERRIE, PATRICIA M (LSA/CST/CFA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:FERRIE
Suffix:
Gender:F
Credentials:LSA/CST/CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75030-0117
Mailing Address - Country:US
Mailing Address - Phone:972-986-3030
Mailing Address - Fax:972-986-9820
Practice Address - Street 1:2301 SAINT ALBENS PL
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-1144
Practice Address - Country:US
Practice Address - Phone:972-986-3030
Practice Address - Fax:972-986-9820
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00068246ZS0410X, 246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
615335300OtherDEPT OF LABOR
TX356498900OtherDEPT OF LABOR
TX0079JROtherBLUE CROSS BLUE SHIELD