Provider Demographics
NPI:1649165606
Name:EMMETT, PATRICK
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:EMMETT
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 1:15711 HAVENROCK CIR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4271
Mailing Address - Country:US
Mailing Address - Phone:214-395-6967
Mailing Address - Fax:
Practice Address - Street 1:15711 HAVENROCK CIR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-4271
Practice Address - Country:US
Practice Address - Phone:214-395-6967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath