Samuel Henry Patton
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Holloman Afb, NM
NPI 1124497623 · NPPES record last updated Sep 15, 2015
Key facts
- NPI
- 1124497623
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 2382 (TX)
- Practice address
- 280 1St St
49 Medical Group
Holloman Afb, NM 88330-8273 - Phone
- (575) 572-5676
- NPI assigned
- Sep 15, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2382 | TX | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2382 | TX | Yes |
Addresses
Primary practice location
280 1St St
49 Medical Group
Holloman Afb, NM 88330-8273
Mailing address
200 1St St.
BLDG 17
Holloman Afb, NM 88330
Phone (575) 572-5676
Other providers in Holloman Afb, NM
- Erin Kathleen O'Pry
- Lauren Danielle Olivares
- Regina Marie Ortega
- Jessica Pagano
- Mary Patric
- John David Paz
- Nicole Ann Percy
- Janice Perido
- Jahna Marie Perrine
- Catherine L. Pitts
All providers in Holloman Afb, NM · Addiction (Substance Use Disorder) Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.