Healthcare Provider Details

I. General information

NPI: 1053931220
Provider Name (Legal Business Name): KEVAN PATEL DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2020
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3143 HIGHWAY 6
SUGAR LAND TX
77478-4367
US

IV. Provider business mailing address

3801 GASTON AVE STE 330
DALLAS TX
75246-1500
US

V. Phone/Fax

Practice location:
  • Phone: 281-980-3668
  • Fax:
Mailing address:
  • Phone: 972-853-4886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number692049
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: