Healthcare Provider Details

I. General information

NPI: 1558380428
Provider Name (Legal Business Name): SHALIN DINESH PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 01/21/2020
Certification Date: 01/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 PARK GROVE LN SUITE 310
KATY TX
77450
US

IV. Provider business mailing address

411 PARK GROVE LN SUITE 310
KATY TX
77450
US

V. Phone/Fax

Practice location:
  • Phone: 281-579-5799
  • Fax: 281-579-5798
Mailing address:
  • Phone: 713-464-9100
  • Fax: 713-468-6183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberM3354
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: