Provider Demographics
NPI:1417948639
Name:PATE, TAMREN ANN (MD)
Entity Type:Individual
Prefix:
First Name:TAMREN
Middle Name:ANN
Last Name:PATE
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 1:1101 N 19TH
Mailing Address - Street 2:STE 107
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601
Mailing Address - Country:US
Mailing Address - Phone:325-670-3800
Mailing Address - Fax:325-670-3803
Practice Address - Street 1:1101 N 19TH
Practice Address - Street 2:STE 107
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601
Practice Address - Country:US
Practice Address - Phone:325-670-3800
Practice Address - Fax:325-670-3803
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8311207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP089Y3816Medicaid
F28894Medicare UPIN
TXP089Y3816Medicaid