Healthcare Provider Details
I. General information
NPI: 1700806668
Provider Name (Legal Business Name): ANAND C PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/20/2006
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3323 COLORADO BLVD STE 105
DENTON TX
76210-6895
US
IV. Provider business mailing address
800 8TH AVE STE 306
FORT WORTH TX
76104-2602
US
V. Phone/Fax
- Phone: 682-224-3748
- Fax: 682-224-3748
- Phone: 682-224-3748
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 01060533A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | MD-19723 |
| License Number State | HI |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | U9625 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: