MEDICARE: NISHA PATEL O.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	152W00000X	Optometrist	6700TG	TX

General Provider Information

NPI Number	:	1801861604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NISHA PATEL O.D.

Provider Business Mailing Address
First Line	:	2401 S STEMMONS FWY
Second Line	:	SUITE 5000
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-8775
Country	:	US
Telephone Number	:	972-459-4737
Fax Number	:	972-315-5786

Provider Business Practice Location Address
First Line	:	2401 S STEMMONS FWY
Second Line	:	SUITE 5000
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-8775
Country	:	US
Telephone Number	:	972-459-4737
Fax Number	:	972-315-5786

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

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	04/07/2016

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Directions to “ NISHA PATEL O.D.” Practice Location

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