Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 2013-01741 | NC |
N | 207L00000X | Anesthesiologist | P3056 | TX |
NPI | 1992965982 |
---|---|
Provider Name | Samir Pravinchandra Patel |
First Address | Carrollton, TX 75011-7614 |
Second Address | San Antonio, TX 78251-4422 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 08/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
296904001 | (05) | TX |
296904002 | CSHCN (01) | TX |