MEDICARE: SHREYA PATEL D.D.S.

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	122300000X	Dentist	40205	TX

General Provider Information

NPI Number	:	1902050594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHREYA PATEL D.D.S.

Provider Business Mailing Address
First Line	:	2201 WHEELER DR
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-2313
Country	:	US
Telephone Number	:	317-938-3161
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 N TARRANT PKWY STE 101
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-7307
Country	:	US
Telephone Number	:	817-534-6455
Fax Number	:

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

Provider Enumeration Date	:	11/09/2008
Last Update Date	:	02/06/2026

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Directions to “ SHREYA PATEL D.D.S.” Practice Location

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