Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | L5868 | TX |
N | 111NI0900X | Internist | L5868 | TX |
Y | 207RN0300X | Nephrologist | L5868 | TX |
N | 2080P0210X | Pediatric Nephrologist | L5868 | TX |
NPI | 1528032042 |
---|---|
Provider Name | Rupert Patel |
First Address | Sugar Land, TX 77478-4072 |
Second Address | Sugar Land, TX 77478-4072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 14/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1736191-01 | (05) | TX |
173619102 | (05) | TX |
173619105 | (05) | TX |
173619106 | (05) | TX |
173619107 | (05) | TX |
173619108 | (05) | TX |
173619109 | (05) | TX |
8BX844 | BCBS INDIVIDUAL NUMBER (01) | TX |
I24443 | (02) |