Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | F6299 | TX |
Y | 207RX0202X | Medical Oncology | F6299 | TX |
NPI | 1063410637 |
---|---|
Provider Name | Jayendra D. Patel |
First Address | Irving, TX 75038-3813 |
Second Address | Texarkana, TX 75503-5220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 14/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
099731403 | (05) | TX |
099731404 | (05) | TX |
100021020A | (05) | OK |
107659001 | (05) | AR |
C20269 | (02) |