1760645824 NPI number — ANIRUDDHA PATEL MD

Table of content: ANIRUDDHA PATEL MD (NPI 1760645824)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760645824 NPI number — ANIRUDDHA PATEL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATEL
Provider First Name:
ANIRUDDHA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1760645824
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3945
Provider Second Line Business Mailing Address:
DEPT 841
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77253-3945
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-358-8114
Provider Business Mailing Address Fax Number:
281-358-0609

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4000 SPENCER HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASADENA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77504-1202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-359-2000
Provider Business Practice Location Address Fax Number:
713-359-1004
Provider Enumeration Date:
07/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  261585 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: P3053 , 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: 306922101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8DJ489 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 306922102 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: P01151448 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com