Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 2292 | TX |
Y | 222Z00000X | Podiatrist | 2292 | TX |
N | 213ES0103X | Foot & Ankle Surgery | 2292 | TX |
NPI | 1093148033 |
---|---|
Provider Name | Payal Patel |
First Address | Granbury, TX 76048-2397 |
Second Address | Granbury, TX 76048-2397 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2013 |
Last Update Date | 16/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
387710201 | (05) | TX |