Provider Demographics
NPI:1841571130
Name:DEEMER, PATRICIA ELLEN (LVN, ATP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ELLEN
Last Name:DEEMER
Suffix:
Gender:F
Credentials:LVN, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 NE LOOP 820
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-2414
Mailing Address - Country:US
Mailing Address - Phone:817-539-2127
Mailing Address - Fax:866-338-0816
Practice Address - Street 1:3515 NW JIM WRIGHT FWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76106-3200
Practice Address - Country:US
Practice Address - Phone:817-529-2127
Practice Address - Fax:866-338-0816
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP 48298247200000X
TXATP48298225CA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other