1427190743 NPI number — PRAVINA PATEL DMD

Table of content: PRAVINA PATEL DMD (NPI 1427190743)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427190743 NPI number — PRAVINA PATEL DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATEL
Provider First Name:
PRAVINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

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:
1427190743
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5901 HILLCROFT ST
Provider Second Line Business Mailing Address:
STE D6
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-781-1170
Provider Business Mailing Address Fax Number:
713-781-6659

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5901 HILLCROFT ST
Provider Second Line Business Practice Location Address:
STE D6
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-781-1170
Provider Business Practice Location Address Fax Number:
713-781-6659
Provider Enumeration Date:
02/13/2007

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: 122300000X , with the licence number:  20764 , 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: 01407989 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: B2076401 . This is a "DELTA DENTAL CHIP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com