Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | MTL002961 | DC |
Y | 207N00000X | Dermatologist | R7559 | TX |
NPI | 1053731927 |
---|---|
Provider Name | Trisha Jayantilal Patel |
First Address | Dallas, TX 75230-5826 |
Second Address | Dallas, TX 75231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2014 |
Last Update Date | 20/08/2018 |