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General NPI Number Information
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NPI Number | 1366743056
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Entity Type | Individual
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Provider Name | RITA PATEL PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/11/2010
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 6636 W WILLIAM CANNON DR APT 522
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City | AUSTIN
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State | TX
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Zip | 78735-8529
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Country | US
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Telephone | 410-207-9188
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Fax |
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Provider Business Mailing Address
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Address Line | 17350 ST LUKES WAY STE 400
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City | THE WOODLANDS
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State | TX
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Zip | 77384-4167
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Country | US
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Telephone | 281-444-3278
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0004311
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA08880
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License Number State | TX
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