1548266570 NPI number — VIPULKUMAR G. PATEL, M.D., P.A.

Table of content: (NPI 1548266570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548266570 NPI number — VIPULKUMAR G. PATEL, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIPULKUMAR G. PATEL, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548266570
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 58233
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEBSTER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77598-8233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-534-8800
Provider Business Mailing Address Fax Number:
281-534-8826

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3828 HUGHES CT
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
DICKINSON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77539-6235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-534-8800
Provider Business Practice Location Address Fax Number:
281-534-8826
Provider Enumeration Date:
06/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
VIPULKUMAR
Authorized Official Middle Name:
G.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
281-534-8814

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3028424 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: DG1973 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00867F . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1542896-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9501450 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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