Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 94-08721 | KS |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | T0312 | TX |
NPI | 1003297904 |
---|---|
Provider Name | Om V Patel |
First Address | Frisco, TX 75034-7399 |
Second Address | Frisco, TX 75034-7399 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2015 |
Last Update Date | 14/10/2021 |