Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | K9864 | TX |
Y | 207XS0106X | Orthopaedic Hand Surgeon | K9864 | TX |
NPI | 1114031929 |
---|---|
Provider Name | Manish V. Patel |
First Address | Phoenix, AZ 85072-2194 |
Second Address | Austin, TX 78745-5257 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 25/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H30660 | (02) |