1548443963 NPI number — JALPA N PATEL PA

Table of content: JALPA N PATEL PA (NPI 1548443963)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548443963 NPI number — JALPA N PATEL PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATEL
Provider First Name:
JALPA
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
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:
1548443963
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/26/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4650 WESTWAY PARK BLVD STE 206
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77041-2006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-461-2915
Provider Business Mailing Address Fax Number:
713-461-5307

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9511 HUFFMEISTER RD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77095-2865
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-461-2915
Provider Business Practice Location Address Fax Number:
713-461-5307
Provider Enumeration Date:
12/07/2007

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: 363A00000X , with the licence number:  04314 , 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: 213124501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".