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PATRICIA D SHORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
504 MEDICAL CENTER BLVD, CONROE, TX 77304-2808
(409) 539-1111
(409) 788-8044
Mailing address
PO BOX 200993, HOUSTON, TX 77216-0993
(281) 784-1111
(281) 784-1555

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
L2647
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150791502
TX
05
150791503
TX
01
1942270772
TRICARE SOUTH
TX
01
8F9646
BC/BS PROVIDER NUMBER
TX
Enumeration date
01/24/2006
Last updated
11/10/2015
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