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General NPI Number Information
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NPI Number | 1053722470
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Entity Type | Individual
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Provider Name | SURAJ J PATEL MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 05/20/2014
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Last Update Date | 10/03/2021
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Provider Practice Location Address
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Address Line | 5939 HARRY HINES BLVD PROFESSIONAL OFFICE BUILDING 2, SUITE 700
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City | DALLAS
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State | TX
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Zip | 75389
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Country | US
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Telephone | 214-645-1919
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 845347
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City | DALLAS
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State | TX
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Zip | 75284-7208
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 273657
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | T3163
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License Number State | TX
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