Provider Demographics
NPI:1598867640
Name:CORRIGAN, PATRICK L (DPM)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:L
Last Name:CORRIGAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 RANCH ROAD 620 S
Mailing Address - Street 2:SUITE C207
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-5615
Mailing Address - Country:US
Mailing Address - Phone:512-263-8655
Mailing Address - Fax:512-263-0346
Practice Address - Street 1:900 RANCH ROAD 620 S
Practice Address - Street 2:SUITE C207
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-5615
Practice Address - Country:US
Practice Address - Phone:512-263-8655
Practice Address - Fax:512-263-0346
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4097213E00000X
TX1872213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00E4097Medicaid
U68595Medicare UPIN
CA00E4097Medicaid
CAE4097Medicare ID - Type UnspecifiedPROVIDER NUMBER