MEDICARE: MR. ASHISH PATEL MS, RPH

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	183500000X	Pharmacist	38788	TX

General Provider Information

NPI Number	:	1700114576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ASHISH PATEL MS, RPH

Provider Business Mailing Address
First Line	:	6812 N LAMAR BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78752-3506
Country	:	US
Telephone Number	:	512-458-4269
Fax Number	:	512-458-3973

Provider Business Practice Location Address
First Line	:	6812 N LAMAR BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78752-3506
Country	:	US
Telephone Number	:	512-458-4269
Fax Number	:	512-458-3973

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

Provider Enumeration Date	:	12/06/2009
Last Update Date	:	12/06/2009

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