Provider Demographics
NPI:1861470007
Name:MAHONEY, PATRICIA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 PERRYTON PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-2817
Mailing Address - Country:US
Mailing Address - Phone:806-665-0801
Mailing Address - Fax:806-665-8503
Practice Address - Street 1:3023 PERRYTON PKWY STE 101
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-2817
Practice Address - Country:US
Practice Address - Phone:806-665-0801
Practice Address - Fax:806-665-8503
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.126066208600000X
MN103202208600000X
TXL2439208600000X
GA90139208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN157485100Medicaid
1861470007OtherMEDICA
TX0095HPOtherBCBS
MN069N7MAOtherBCBS
IA1861470007Medicaid
974311051958OtherPREFERREDONE
18722OtherAVERA HEALTH
139560OtherUCARE
TX150706301Medicaid
1861470007OtherAMERICAS PPO
60563OtherSANFORD
HP84008OtherHEALTHPARTNERS
974311051958OtherPREFERREDONE
974311051958OtherPREFERREDONE
18722OtherAVERA HEALTH
139560OtherUCARE
1861470007OtherMEDICA