MEDICARE: ASHVINKUMAR N PATEL M.D.

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	207RN0300X	Nephrology Physician	K1614	TX

General Provider Information

NPI Number	:	1528129871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHVINKUMAR N PATEL M.D.

Provider Business Mailing Address
First Line	:	1517 10TH ST
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-4404
Country	:	US
Telephone Number	:	940-322-1411
Fax Number	:	940-322-2120

Provider Business Practice Location Address
First Line	:	1517 10TH ST
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-4404
Country	:	US
Telephone Number	:	940-322-1411
Fax Number	:	940-322-2120

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	07/08/2007

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