Provider Demographics
NPI:1750362133
Name:PATEK, AMY HSU (OD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:HSU
Last Name:PATEK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:S
Other - Last Name:HSU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:413 ROCKY POINTE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912
Mailing Address - Country:US
Mailing Address - Phone:626-688-6341
Mailing Address - Fax:
Practice Address - Street 1:1850 N ZARAGOZA RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7911
Practice Address - Country:US
Practice Address - Phone:915-581-4497
Practice Address - Fax:818-238-0252
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11655TPL152W00000X
TX7856T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU88050Medicare UPIN
CAOP11655Medicare ID - Type UnspecifiedPPIN