Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | R3579 | TX |
Y | 207QS0010X | Family Doctor - Sports Medicine | R3579 | TX |
NPI | 1154718971 |
---|---|
Provider Name | Dr. Rajen Patel |
First Address | San Antonio, TX 78236-5638 |
Second Address | San Antonio, TX 78236-5638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2015 |
Last Update Date | 22/04/2020 |