Provider Demographics
NPI:1699778043
Name:PATTON, GREGORY JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JOHN
Last Name:PATTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10611 GARLAND RD
Mailing Address - Street 2:STE 106
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-2681
Mailing Address - Country:US
Mailing Address - Phone:214-320-0010
Mailing Address - Fax:214-327-6050
Practice Address - Street 1:8511 S SAM HOUSTON PKWY E
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-4874
Practice Address - Country:US
Practice Address - Phone:713-343-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7142207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81G571OtherBCBS
TX114784503Medicaid
TX346620YLGGMedicare PIN
TX81G571Medicare PIN
TXC20307Medicare UPIN
TX114784503Medicaid