Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 32132 | TX |
NPI | 1003262098 |
---|---|
Provider Name | Dhanish Patel |
First Address | Sunnyvale, TX 75182-4033 |
Second Address | Austin, TX 78745-5327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2016 |
Last Update Date | 26/09/2018 |