Basic Information
| Provider Information | |||||||||
| NPI: | 1356605497 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATCHEN | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2445 W OAK ST | ||||||||
| Address2: | 200 | ||||||||
| City: | DENTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762014325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9403206030 | ||||||||
| FaxNumber: | 9403203113 | ||||||||
| Practice Location | |||||||||
| Address1: | 2445 W OAK ST | ||||||||
| Address2: | 200 | ||||||||
| City: | DENTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762014325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9403206030 | ||||||||
| FaxNumber: | 9403203113 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2012 | ||||||||
| LastUpdateDate: | 08/09/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1221460 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.