Healthcare Provider Details

I. General information

NPI: 1528486438
Provider Name (Legal Business Name): KUNAL VIJAYKUMAR PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2014
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2604 SAINT MICHAEL DR STE 345
TEXARKANA TX
75503-2378
US

IV. Provider business mailing address

3427 CEDAR SPRINGS RD APT 1403
DALLAS TX
75219-3260
US

V. Phone/Fax

Practice location:
  • Phone: 903-838-5500
  • Fax: 903-838-7402
Mailing address:
  • Phone: 562-650-0811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberS2453
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberS2453
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberS2453
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: