Provider Demographics
NPI:1578659397
Name:BUDD, PATRICE PATTON (PNP)
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:PATTON
Last Name:BUDD
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 OAK PARK DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4091
Mailing Address - Country:US
Mailing Address - Phone:512-255-3670
Mailing Address - Fax:512-389-2974
Practice Address - Street 1:3311 FM 973 SOUTH
Practice Address - Street 2:
Practice Address - City:DEL VALLE
Practice Address - State:TX
Practice Address - Zip Code:78617
Practice Address - Country:US
Practice Address - Phone:512-386-3335
Practice Address - Fax:512-389-2974
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX455282363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics