Provider Demographics
NPI:1699197186
Name:PATTERSON, BRIAN (LCDC)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5633 SOUTH STAPLES
Mailing Address - Street 2:700
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2046
Mailing Address - Country:US
Mailing Address - Phone:361-814-5200
Mailing Address - Fax:361-883-1998
Practice Address - Street 1:5633 S STAPLES ST
Practice Address - Street 2:700
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4646
Practice Address - Country:US
Practice Address - Phone:361-814-2001
Practice Address - Fax:361-883-1998
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12383101YA0400X
TX171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)