Provider Demographics
NPI:1639164809
Name:FORD, PATRICK VAUGHN (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:VAUGHN
Last Name:FORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6720 BERTNER ST
Mailing Address - Street 2:DEPT. OF NUCLEAR MEDICINE - SLEH MC3-261
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2604
Mailing Address - Country:US
Mailing Address - Phone:832-355-2065
Mailing Address - Fax:832-355-3363
Practice Address - Street 1:6720 BERTNER ST
Practice Address - Street 2:DEPT. OF NUCLEAR MEDICINE - SLEH MC3-261
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2604
Practice Address - Country:US
Practice Address - Phone:832-355-2065
Practice Address - Fax:832-366-3363
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG3360207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine