Provider Demographics
NPI:1477578565
Name:MOSSBURG, PATRICIA TERESA (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:TERESA
Last Name:MOSSBURG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1619 E COMMON ST STE 1201
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3464
Mailing Address - Country:US
Mailing Address - Phone:830-312-7697
Mailing Address - Fax:830-312-7666
Practice Address - Street 1:1619 E COMMON ST STE 1201
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3464
Practice Address - Country:US
Practice Address - Phone:830-312-7697
Practice Address - Fax:830-312-7666
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7490207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH95939Medicare UPIN
TX8D6237Medicare PIN