MEDICARE: DR. DIPSU DILIP 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	207RC0000X	Cardiovascular Disease Physician	M2742	TX

General Provider Information

NPI Number	:	1760624951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIPSU DILIP PATEL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 890089
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77289-0089
Country	:	US
Telephone Number	:	409-945-5444
Fax Number	:	409-945-4133

Provider Business Practice Location Address
First Line	:	6807 EMMETT F LOWRY EXPY STE 108
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591-2547
Country	:	US
Telephone Number	:	409-945-5444
Fax Number	:	409-945-4133

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

Provider Enumeration Date	:	04/02/2009
Last Update Date	:	09/08/2010

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