Healthcare Provider Details

I. General information

NPI: 1306778360
Provider Name (Legal Business Name): ANIL D PATEL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 RENAISSANCE BLVD STE 120
EDMOND OK
73013-3023
US

IV. Provider business mailing address

1800 RENAISSANCE BLVD STE 120
EDMOND OK
73013-3023
US

V. Phone/Fax

Practice location:
  • Phone: 908-748-4480
  • Fax: 732-451-3435
Mailing address:
  • Phone: 908-748-4480
  • Fax: 732-451-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANIL PATEL
Title or Position: OWNER
Credential: MD
Phone: 908-748-4480