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General NPI Number Information
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NPI Number | 1366928913
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Entity Type | Individual
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Provider Name | VISHWAM PINAKIN PATEL
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Gender | Male
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 07/17/2018
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Provider Practice Location Address
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Address Line | 661 E MAIN ST STE 800
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City | MIDLOTHIAN
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State | TX
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Zip | 76065-3342
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Country | US
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Telephone | 682-773-3072
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 PLEASANT OAKS DR
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City | LEWISVILLE
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State | TX
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Zip | 75067-2006
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Country | US
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Telephone | 972-363-7331
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 34225
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License Number State | TX
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