Individual
TODD A PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
910 E HOUSTON ST, STE 330, TYLER, TX 75702-8369
(903) 525-7995
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
44797
MN
207T00000X
Neurological Surgery Physician
Primary
N1052
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
689448800
—
MN
01
—
8BC076
BCBS OF TEXAS
TX
Enumeration date
01/06/2006
Last updated
10/13/2014
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