Provider Demographics
NPI:1447500764
Name:ADCOCK, PATRICIA C (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:C
Last Name:ADCOCK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 RAINBOW DR # 3544
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77399-1035
Mailing Address - Country:US
Mailing Address - Phone:281-825-8442
Mailing Address - Fax:
Practice Address - Street 1:1 CORONADO TRCE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71909-5436
Practice Address - Country:US
Practice Address - Phone:281-825-8442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1862101YP2500X
TX189178106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX$$$$$$$$$OtherSSN