Provider Demographics
NPI:1619996188
Name:MCLEAN, PATRICK (OTR, CHT)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:MCLEAN
Suffix:
Gender:M
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ORTHOPEDIC WAY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-1629
Mailing Address - Country:US
Mailing Address - Phone:817-375-5200
Mailing Address - Fax:817-299-1706
Practice Address - Street 1:2801 E BROAD ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-9128
Practice Address - Country:US
Practice Address - Phone:817-375-5200
Practice Address - Fax:817-299-1706
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107798225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J3510Medicare PIN