Healthcare Provider Details

I. General information

NPI: 1649026980
Provider Name (Legal Business Name): RICHA RAJENDRA PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 4TH ST
ALEXANDRIA LA
71301-8421
US

IV. Provider business mailing address

2145 HORSESHOE DR APT 4134
ALEXANDRIA LA
71301-2026
US

V. Phone/Fax

Practice location:
  • Phone: 318-769-3000
  • Fax:
Mailing address:
  • Phone: 847-868-4211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: