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General NPI Number Information
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NPI Number | 1346853348
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Entity Type | Organization
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Legal Business Name | SHIV PATEL MD PA
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 215 OLD HIGHWAY 1187
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City | BURLESON
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State | TX
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Zip | 76028-0281
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Country | US
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Telephone | 817-926-2663
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Fax | 817-293-8860
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Provider Business Mailing Address
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Address Line | 215 OLD HIGHWAY 1187
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City | BURLESON
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State | TX
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Zip | 76028-0281
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Country | US
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Telephone | 817-926-2663
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Fax | 817-293-8860
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | DIDI BELL
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Credential |
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Telephone | 817-926-2663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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