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General NPI Number Information
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NPI Number | 1235149600
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Entity Type | Individual
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Provider Name | SHEETAL PATEL GOLLA M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 3131 MEMORIAL CT APT # 12104
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City | HOUSTON
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State | TX
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Zip | 77007-6175
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Country | US
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Telephone | 312-933-2392
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Fax |
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Provider Business Mailing Address
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Address Line | 411 PARK GROVE LN SUITE 310 APT # 12104
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City | KATY
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State | TX
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Zip | 77450-6175
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Country | US
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Telephone | 713-464-9100
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Fax | 713-468-6183
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | P2050
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License Number State | TX
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