Provider Demographics
NPI:1811347768
Name:PATTERSON, ROBERT CHASE (DPT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHASE
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 NORTHPOINTE LN
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-3879
Mailing Address - Country:US
Mailing Address - Phone:318-255-9601
Mailing Address - Fax:
Practice Address - Street 1:2035 FORT WORTH HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086
Practice Address - Country:US
Practice Address - Phone:817-599-9271
Practice Address - Fax:817-599-9295
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1274809225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist