Provider Demographics
NPI:1407840861
Name:PATTERSON, HEATHER E (DPT ATC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:E
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DPT ATC
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:E
Other - Last Name:HARPEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT ATC
Mailing Address - Street 1:1103 CYPRESS CREKK ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:512-868-0820
Mailing Address - Fax:
Practice Address - Street 1:1103 CYPRESS CREEK RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3924
Practice Address - Country:US
Practice Address - Phone:512-918-0044
Practice Address - Fax:512-918-0045
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1440225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKPT2540Medicaid
7490593OtherAETNA
AKPT2540Medicaid