Provider Demographics
NPI:1891939252
Name:PATNIYOT, IRENE
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:PATNIYOT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BAYLOR COLLEGE OF MEDICINE 6701 FANNIN
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-0001
Mailing Address - Country:US
Mailing Address - Phone:832-822-1750
Mailing Address - Fax:
Practice Address - Street 1:BAYLOR COLLEGE OF MEDICINE 6701 FANNIN
Practice Address - Street 2:SUITE 1250
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-0001
Practice Address - Country:US
Practice Address - Phone:832-822-1750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ98752084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology