Healthcare Provider Details

I. General information

NPI: 1386610954
Provider Name (Legal Business Name): RAJEEV PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HOSPITAL PKWY
BEDFORD TX
76022-6913
US

IV. Provider business mailing address

5013 STONEWICK CT
PLANO TX
75093-3457
US

V. Phone/Fax

Practice location:
  • Phone: 817-685-4619
  • Fax:
Mailing address:
  • Phone: 469-688-2351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberJ6648
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: