Provider Demographics
NPI:1083089080
Name:PATTISON FIRST FAMILY CLINIC LLC
Entity type:Organization
Organization Name:PATTISON FIRST FAMILY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWOLABI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-934-4444
Mailing Address - Street 1:3603 FRONT ST STE 102-103
Mailing Address - Street 2:
Mailing Address - City:BROOKSHIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77423-9845
Mailing Address - Country:US
Mailing Address - Phone:281-934-4444
Mailing Address - Fax:281-934-4443
Practice Address - Street 1:3603 FRONT ST
Practice Address - Street 2:SUITE: 102- 103
Practice Address - City:BROOKSHIRE
Practice Address - State:TX
Practice Address - Zip Code:77423-9845
Practice Address - Country:US
Practice Address - Phone:281-934-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care