MEDICARE: DR. ANKIT PATEL P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center	M8909	TX

General Provider Information

NPI Number	:	1104218619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. ANKIT PATEL P.A.

Provider Business Mailing Address
First Line	:	1778 TORREY PINES LN
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-6926
Country	:	US
Telephone Number	:	469-348-8521
Fax Number	:

Provider Business Practice Location Address
First Line	:	3825 E BELKNAP ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76111-6020
Country	:	US
Telephone Number	:	469-348-8521
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. ANKIT PATEL
Credential	:	DO
Telephone Number	:	469-348-8521

Provider Enumeration Date	:	02/21/2015
Last Update Date	:	02/21/2015

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