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NPI Code Detail

MEDICARE: KRISHNA PATEL NP-C

MEDICARE:   KRISHNA  PATEL  NP-C
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
1363LG0600XGerontology Nurse Practitioner825255784TX

General Provider Information

NPI Number : 1447905708
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISHNA PATEL NP-C
Provider Business Mailing Address
First Line : 3107 N MAIN ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76106-5833
Country : US
Telephone Number : 817-726-8411
Fax Number :
Provider Business Practice Location Address
First Line : 2917 CROCKETT STREET
Second Line :
City : FORT WORTH
State : TX
Zip : 76107
Country : US
Telephone Number : 817-385-4814
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2022
Last Update Date : 02/15/2022

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