Provider Demographics
NPI:1306823349
Name:LADEN, PATRICIA E (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:E
Last Name:LADEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17183 I 45 S STE 670
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3316
Mailing Address - Country:US
Mailing Address - Phone:936-321-8221
Mailing Address - Fax:936-321-8229
Practice Address - Street 1:17183 I 45 S STE 670
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-3316
Practice Address - Country:US
Practice Address - Phone:936-321-8221
Practice Address - Fax:936-321-8229
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2521207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033251201Medicaid
TX00F89GMedicare ID - Type Unspecified
TXE45824Medicare UPIN