Provider Demographics
NPI:1942221510
Name:POHLMANN-PATTERSON, JENNIFER GABRIELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:GABRIELLE
Last Name:POHLMANN-PATTERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:GABRIELLE
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:403 W CAMPBELL RD
Mailing Address - Street 2:STE 410
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3465
Mailing Address - Country:US
Mailing Address - Phone:972-498-8670
Mailing Address - Fax:972-498-8676
Practice Address - Street 1:403 W CAMPBELL RD
Practice Address - Street 2:STE 410
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3465
Practice Address - Country:US
Practice Address - Phone:972-498-8670
Practice Address - Fax:972-498-8676
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5653207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH19008Medicare UPIN