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General NPI Number Information
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NPI Number | 1154504025
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Entity Type | Organization
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Legal Business Name | PADMAJA M PATEL MDPA
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 3001 W ILLINOIS AVE STE 2B2
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City | MIDLAND
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State | TX
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Zip | 79701-3113
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Country | US
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Telephone | 432-689-0291
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Fax | 432-689-0205
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Provider Business Mailing Address
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Address Line | 3001 W ILLINOIS AVE STE 2B2
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City | MIDLAND
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State | TX
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Zip | 79701-3113
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Country | US
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Telephone | 432-689-0291
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Fax | 432-689-0205
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Authorized Official
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Title or Position | OWNER
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Name | PADMAJA M PATEL
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Credential | MD
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Telephone | 432-699-1904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K6681
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License Number State | TX
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