Healthcare Provider Details

I. General information

NPI: 1851093009
Provider Name (Legal Business Name): REEMA SHAILESH PATEL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 MUELLER BLVD
AUSTIN TX
78723-3079
US

IV. Provider business mailing address

4900 MUELLER BLVD
AUSTIN TX
78723-3079
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-3315
  • Fax:
Mailing address:
  • Phone: 512-324-3315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberW5499
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberW5499
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: