MEDICARE: HETALBEN P PATEL

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	44109	TX

General Provider Information

NPI Number	:	1770810731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HETALBEN P PATEL

Provider Business Mailing Address
First Line	:	2808 GESSNER DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-2504
Country	:	US
Telephone Number	:	713-460-0535
Fax Number	:	713-460-0559

Provider Business Practice Location Address
First Line	:	2808 GESSNER DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-2504
Country	:	US
Telephone Number	:	713-460-0535
Fax Number	:	713-460-0559

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

Provider Enumeration Date	:	11/12/2009
Last Update Date	:	11/12/2009

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Directions to “ HETALBEN P PATEL ” Practice Location

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