Organization
PATRICK T. ROUGHNEEN, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMCHI T NGUYEN (OFFICE MANAGER)
(817) 552-1900
Entity
Organization
Contact information
Practice address
1600 W COLLEGE ST, SUITE 555, GRAPEVINE, TX 76051-3580
(817) 552-1900
(817) 552-1902
Mailing address
1600 W COLLEGE ST, SUITE 555, GRAPEVINE, TX 76051-3580
(817) 552-1900
(817) 552-1902
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J1480
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171001404
—
TX
Enumeration date
05/10/2007
Last updated
05/14/2010
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