Provider Demographics
NPI:1487615274
Name:PATTERSON, BRENT ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:ANDREW
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 N PRESIDENT GEORGE BUSH HWY STE 206
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2208
Mailing Address - Country:US
Mailing Address - Phone:972-276-8994
Mailing Address - Fax:844-292-1462
Practice Address - Street 1:7150 N PRESIDENT GEORGE BUSH HWY STE 206
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-2208
Practice Address - Country:US
Practice Address - Phone:972-276-8994
Practice Address - Fax:844-292-1462
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5433207UN0901X, 207RC0000X
ORMD25730207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR270032Medicaid
TX8L14634OtherMEDICARE ID
ORR133196Medicare ID - Type Unspecified
OR270032Medicaid