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NPI Code Detail

MEDICARE: KISHAN PATEL DO

MEDICARE: KISHAN PATEL DO
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
1208100000XPhysical Medicine & Rehabilitation Physician34.018002OH
2390200000XStudent in an Organized Health Care Education/Training Program

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578143632
Entity Type Code : Individual
Provider Name (Legal Business Name) : KISHAN PATEL DO
Provider Business Mailing Address
First Line : 1776 WOODSTEAD CT STE 208
Second Line :
City : THE WOODLANDS
State : TX
Zip : 77380-1480
Country : US
Telephone Number : 877-749-7428
Fax Number :
Provider Business Practice Location Address
First Line : 33355 HEALTH CAMPUS BLVD
Second Line :
City : AVON
State : OH
Zip : 44011-1399
Country : US
Telephone Number : 440-934-0489
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2021
Last Update Date : 12/02/2025

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Directions to “ KISHAN PATEL DO” Practice Location

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