Healthcare Provider Details

I. General information

NPI: 1578147435
Provider Name (Legal Business Name): NIDHI PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2021
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 W. WHEATLAND RD
DALLAS TX
75237
US

IV. Provider business mailing address

3500 W. WHEATLAND RD
DALLAS TX
75237
US

V. Phone/Fax

Practice location:
  • Phone: 214-947-5420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberV0101
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberBP10074705
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: