Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 1368 | TX |
NPI | 1023047909 |
---|---|
Provider Name | Scott Thomas Pattison |
First Address | Georgetown, TX 78626-7545 |
Second Address | Georgetown, TX 78626-7545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 23/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
112181602 | (05) | TX |
8A2741 | BLUECROSS/BLUESHIELD (01) | TX |
U66468 | (02) | TX |