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General NPI Number Information
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NPI Number | 1093114530
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Entity Type | Organization
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Legal Business Name | PATEL SURGICAL PLLC
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 909 9TH AVE STE 208
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City | FORT WORTH
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State | TX
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Zip | 76104-3931
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Country | US
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Telephone | 817-332-0789
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Fax |
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Provider Business Mailing Address
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Address Line | 909 9TH AVE STE 208
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City | FORT WORTH
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State | TX
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Zip | 76104-3931
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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 | OWNER
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Name | DR. JAY PATEL
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Credential | D.O.
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Telephone | 817-332-0789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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