Basic Information
| Provider Information | |||||||||
| NPI: | 1255542197 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATTISON | ||||||||
| FirstName: | MONTA | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 921 GESSNER RD. | ||||||||
| Address2: | DEPARTMENT OF EMERGENCY MEDICAL SERVICES | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7132423000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 921 GESSNER RD | ||||||||
| Address2: | DEPARTMENT OF EMERGENCY MEDICAL SERVICES | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770242501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7132423000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2007 | ||||||||
| LastUpdateDate: | 06/24/2009 | ||||||||
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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 | 207P00000X | 0000 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 07804 | 05 | LA | MEDICAID |