Provider Demographics
NPI:1033972765
Name:PATTI, SANDRA IRIS (APN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:IRIS
Last Name:PATTI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2826 REDRIVER HL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-3555
Mailing Address - Country:US
Mailing Address - Phone:210-901-4622
Mailing Address - Fax:
Practice Address - Street 1:4400 FREDERICKSBURG RD STE 106
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-1969
Practice Address - Country:US
Practice Address - Phone:210-317-5111
Practice Address - Fax:210-317-9111
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1141868363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics