Active NPI
Patrick M Fitzwater, PA-C
- Medical Physician Assistant
- Houston, TX
National Provider Identifier
1154509602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA 02759
- Practice address
- 1615 Hillendahl Blvd
Suite 100
Houston, TX 77055-3402 - Phone
- (713) 462-6565
- Fax
- (713) 462-6581
- NPI assigned
- Feb 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA 02759 | TX | Primary |
Addresses
Primary practice location
1615 Hillendahl Blvd
Suite 100
Houston, TX 77055-3402
Mailing address
1615 Hillendahl Blvd
Suite 100
Houston, TX 77055-3402
Phone (713) 462-6565
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 02759 | TX | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial City Emergency Physicians, LLP | Past | Accepting new patients | |
| Woodlands Emergency Physicians, LLP | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Houston, TX
- NPI 1992730246
-
- Emergency Medicine Physician
- The Woodlands, TX
- NPI 1245265537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388707200000",
"number": "1154509602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1615 HILLENDAHL BLVD",
"address_2": "SUITE 100",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770553402",
"telephone_number": "713-462-6565",
"fax_number": "713-462-6581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 HILLENDAHL BLVD",
"address_2": "SUITE 100",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770553402",
"telephone_number": "713-462-6565",
"fax_number": "713-462-6581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZWATER",
"first_name": "PATRICK",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-07",
"last_updated": "2014-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA 02759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.