Healthcare Provider Details

I. General information

NPI: 1992854830
Provider Name (Legal Business Name): DHRUV PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 10/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLEAR LAKE REGIONAL MEDICAL CENTER 500 MEDICAL CENTER BLVD
WEBSTER TX
77598
US

IV. Provider business mailing address

439 FAUST LN
HOUSTON TX
77024-4701
US

V. Phone/Fax

Practice location:
  • Phone: 281-338-3962
  • Fax:
Mailing address:
  • Phone: 832-443-7657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberN2716
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberN2716
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberN2716
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: