Organization Active NPI

Brent E Patterson

  • Durable Medical Equipment & Medical Supplies
  • League City, TX
National Provider Identifier
1124473269
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
19046 Issued in TX
Legal business name
BRENT E PATTERSON
Practice address
3891 E League City Pkwy
League City, TX 77573-1551
Phone
(281) 557-7747
Fax
(281) 334-3264
NPI assigned
Apr 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Brent E Patterson, D.D.S.
Title
Owner
Phone
(409) 739-2242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 19046 TX Primary

Addresses

Primary practice location

3891 E League City Pkwy
League City, TX 77573-1551

Mailing address

3891 E League City Pkwy
League City, TX 77573-1551
Phone (281) 557-7747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161026001426 TX DME Supplier - Oral Surgery - Dentist 3274811286 Practice locations: League City, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

3891 E League City Pkwy
League City, TX 77573
Phone (281) 557-7747

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1124473269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3891 E LEAGUE CITY PKWY",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775731551",
            "telephone_number": "281-557-7747",
            "fax_number": "281-334-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3891 E LEAGUE CITY PKWY",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775731551",
            "telephone_number": "281-557-7747",
            "fax_number": "281-334-3264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT E PATTERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-739-2242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "19046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.