Healthcare Provider Details

I. General information

NPI: 1609317262
Provider Name (Legal Business Name): SOUTH DALLAS INFECTIOUS DISEASES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 MATLOCK RD STE 107
ARLINGTON TX
76015-2905
US

IV. Provider business mailing address

2101 SHANNON OXMOOR RD # 82
SHANNON AL
35142-2000
US

V. Phone/Fax

Practice location:
  • Phone: 888-212-4243
  • Fax:
Mailing address:
  • Phone: 888-212-4243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberP3055
License Number StateTX

VIII. Authorized Official

Name: DR. RONAK JASHVANTRAY PATEL
Title or Position: VICE PRESIDENT
Credential: M.D.
Phone: 888-212-4243