Provider Demographics
NPI:1285752709
Name:PATTON, MARY LYNN (EDD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:LYNN
Last Name:PATTON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N POST OAK LN
Mailing Address - Street 2:#400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-7715
Mailing Address - Country:US
Mailing Address - Phone:512-771-4177
Mailing Address - Fax:240-332-2338
Practice Address - Street 1:123 N POST OAK LN
Practice Address - Street 2:#400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-7715
Practice Address - Country:US
Practice Address - Phone:512-771-4177
Practice Address - Fax:240-332-2338
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32809103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical