Provider Demographics
NPI:1811324080
Name:PATTERSON, BYRON HEATH (PHARM D)
Entity type:Individual
Prefix:
First Name:BYRON
Middle Name:HEATH
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 IDLE CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-7536
Mailing Address - Country:US
Mailing Address - Phone:325-370-1204
Mailing Address - Fax:
Practice Address - Street 1:210 SW GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556
Practice Address - Country:US
Practice Address - Phone:325-235-4077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50825183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX50825OtherTEXAS STATE BOARD OF PHARMACY