Provider Demographics
NPI:1639654080
Name:PATTERSON, CHILIBRA (OTR)
Entity type:Individual
Prefix:
First Name:CHILIBRA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10107 DAVINCI COURT
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583
Mailing Address - Country:US
Mailing Address - Phone:713-320-6949
Mailing Address - Fax:
Practice Address - Street 1:1112 SMITH DR
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-5562
Practice Address - Country:US
Practice Address - Phone:281-331-6125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110557225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist