Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | M3682 | TX |
N | 207VG0400X | Gynecologist | M3682 | TX |
NPI | 1336131812 |
---|---|
Provider Name | Dr. Amit Indravadan Patel |
First Address | Dallas, TX 75219-4301 |
Second Address | Plano, TX 75093-8497 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 10/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1818411 | (05) | TX |
7323792 | AETNA (01) | TX |
8DM546 | BCBS PROVIDER # (01) | TX |
I60630 | (02) | TX |