Healthcare Provider Details

I. General information

NPI: 1386750073
Provider Name (Legal Business Name): PARESH PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 06/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6675 HOLMES RD SUITE 430
KANSAS CITY MO
64131-1150
US

IV. Provider business mailing address

6675 HOLMES RD SUITE 430
KANSAS CITY MO
64131-1150
US

V. Phone/Fax

Practice location:
  • Phone: 816-361-0055
  • Fax: 816-361-5775
Mailing address:
  • Phone: 816-361-0055
  • Fax: 816-361-5775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0431054
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2004034161
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: