Healthcare Provider Details
I. General information
NPI: 1013017912
Provider Name (Legal Business Name): JOLET PATIL AND RIMER PEDIATRICS PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2006
Last Update Date: 05/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7900 FM 1826 220
AUSTIN TX
78737-1407
US
IV. Provider business mailing address
7900 FM 1826 220
AUSTIN TX
78737-1407
US
V. Phone/Fax
- Phone: 512-288-9669
- Fax: 512-498-0317
- Phone: 512-288-9669
- Fax: 512-498-0317
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | L2538 |
| License Number State | TX |
VIII. Authorized Official
Name:
VAISHALEE
SANJAY
PATIL
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 512-288-9669