Healthcare Provider Details

I. General information

NPI: 1003822859
Provider Name (Legal Business Name): MILAN PATEL MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6611 AMARILLO BLVD W
AMARILLO TX
79106-1755
US

IV. Provider business mailing address

PO BOX 51552
AMARILLO TX
79159-1552
US

V. Phone/Fax

Practice location:
  • Phone: 806-358-8011
  • Fax: 806-358-2232
Mailing address:
  • Phone: 806-358-8011
  • Fax: 806-358-2232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License NumberJ7126
License Number StateTX

VIII. Authorized Official

Name: MILAN K PATEL
Title or Position: PRESIDENT
Credential: MD
Phone: 806-358-8011