Provider Demographics
NPI:1295718716
Name:PATT, BRADFORD STEWART (MD)
Entity type:Individual
Prefix:
First Name:BRADFORD
Middle Name:STEWART
Last Name:PATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14140 SOUTHWEST FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3842
Mailing Address - Country:US
Mailing Address - Phone:281-649-7000
Mailing Address - Fax:713-484-6649
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:SUITE 235
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2527
Practice Address - Country:US
Practice Address - Phone:281-649-7170
Practice Address - Fax:713-984-0497
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3501207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122688802Medicaid
TXD97617Medicare UPIN
TXD97617Medicare UPIN