Healthcare Provider Details

I. General information

NPI: 1528078466
Provider Name (Legal Business Name): DHIREN B. PATEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 04/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 PRUDENTIAL DR
DALLAS TX
75235-4109
US

IV. Provider business mailing address

1475 PRUDENTIAL DR
DALLAS TX
75235-4109
US

V. Phone/Fax

Practice location:
  • Phone: 214-522-4640
  • Fax: 214-522-4650
Mailing address:
  • Phone: 214-522-4640
  • Fax: 214-522-4650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberJ4423
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberJ4423
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: