Provider Demographics
NPI:1841649167
Name:PATTERSON, DAVID (CO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 W 1630 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-8615
Mailing Address - Country:US
Mailing Address - Phone:435-962-0524
Mailing Address - Fax:801-392-0797
Practice Address - Street 1:230 SPRING HILL DR
Practice Address - Street 2:335
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2381
Practice Address - Country:US
Practice Address - Phone:281-296-8999
Practice Address - Fax:281-296-8989
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO005620222Z00000X
TXCO005620222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist