Healthcare Provider Details

I. General information

NPI: 1043867724
Provider Name (Legal Business Name): MR. NEVIL PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2019
Last Update Date: 06/26/2020
Certification Date: 06/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2407 WAUGH DR
HOUSTON TX
77006-2507
US

IV. Provider business mailing address

12911 TRAVIATA DR
HOUSTON TX
77024-4728
US

V. Phone/Fax

Practice location:
  • Phone: 281-748-5470
  • Fax:
Mailing address:
  • Phone: 281-748-5470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: