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General NPI Number Information
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NPI Number | 1346608775
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Entity Type | Individual
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Provider Name | DIXITA PATEL NP
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Gender | Female
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Dates
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Enumeration Date | 01/30/2016
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 1500 S MAIN ST
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City | FORT WORTH
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State | TX
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Zip | 76104-4917
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Country | US
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Telephone | 817-702-1166
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Fax |
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Provider Business Mailing Address
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Address Line | 4201 W MEDICAL CENTER DR
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City | MCHENRY
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State | IL
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Zip | 60050
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Country | US
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Telephone | 815-338-6600
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209-012717
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209012717
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP142211
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License Number State | TX
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