Healthcare Provider Details

I. General information

NPI: 1134810518
Provider Name (Legal Business Name): PURVI PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 S I 35 SERVICE RD
MOORE OK
73160-9046
US

IV. Provider business mailing address

13901 CASCATA STRADA
OKLAHOMA CITY OK
73170-5175
US

V. Phone/Fax

Practice location:
  • Phone: 405-601-4303
  • Fax:
Mailing address:
  • Phone: 405-694-7741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: