Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 8312-T | TX |
NPI | 1003248907 |
---|---|
Provider Name | Dr. Ajay S Patel |
First Address | Frisco, TX 75034-7480 |
Second Address | Frisco, TX 75034-7478 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2013 |
Last Update Date | 22/04/2014 |