Provider Demographics
NPI:1811279953
Name:PATBAR LLC
Entity type:Organization
Organization Name:PATBAR LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:
Authorized Official - Last Name:BALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-549-4785
Mailing Address - Street 1:4514 ROWLETT ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088
Mailing Address - Country:US
Mailing Address - Phone:469-549-4785
Mailing Address - Fax:972-219-5371
Practice Address - Street 1:4514 ROWLETT ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088
Practice Address - Country:US
Practice Address - Phone:469-549-4785
Practice Address - Fax:972-219-5371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013205251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health