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General NPI Number Information
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NPI Number | 1215015292
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Entity Type | Organization
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Legal Business Name | SANDEEP B. PATEL, D.D.S., P.A.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 411 BRAZOS ST UNIT #206
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City | AUSTIN
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State | TX
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Zip | 78701-3698
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Country | US
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Telephone | 512-233-6200
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Fax | 512-233-6201
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Provider Business Mailing Address
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Address Line | 11215 S. IH-35 SUITE#116
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City | AUSTIN
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State | TX
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Zip | 78747
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Country | US
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Telephone | 512-233-6200
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Fax | 512-233-6201
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANDEEP B PATEL
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Credential | D.D.S.
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Telephone | 512-233-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 21274
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License Number State | TX
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