Provider Demographics
NPI:1972844785
Name:PATLAN, JOSE ALFREDO
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ALFREDO
Last Name:PATLAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-5638
Mailing Address - Country:US
Mailing Address - Phone:830-278-2581
Mailing Address - Fax:830-591-1842
Practice Address - Street 1:227 E MAIN ST
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-5638
Practice Address - Country:US
Practice Address - Phone:830-278-2581
Practice Address - Fax:830-591-1842
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24046183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist