Provider Demographics
NPI:1720877640
Name:PATTERSON, LLOYD TARIAL
Entity type:Individual
Prefix:
First Name:LLOYD
Middle Name:TARIAL
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 HARRY WURZBACH RD APT 1101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-5020
Mailing Address - Country:US
Mailing Address - Phone:650-630-2994
Mailing Address - Fax:
Practice Address - Street 1:2530 HARRY WURZBACH RD APT 1101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5020
Practice Address - Country:US
Practice Address - Phone:650-630-2994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50861-0523175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist