Provider Demographics
NPI:1295484228
Name:O'TOOLE, PATRICK WILLIAM
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:WILLIAM
Last Name:O'TOOLE
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 1:4 GANNET HOLLOW PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-4003
Mailing Address - Country:US
Mailing Address - Phone:936-777-5115
Mailing Address - Fax:
Practice Address - Street 1:4 GANNET HOLLOW PL
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-4003
Practice Address - Country:US
Practice Address - Phone:936-777-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPF1205242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist