=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376739896
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PATEL CARDIOLOGY LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2007
-----------------------------------------------------
Last Update Date | 06/21/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4275 BURNHAM AVE SUITE 335
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89119-5488
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-731-5510
-----------------------------------------------------
Fax | 702-731-5530
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 370878
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89137-0878
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-731-5510
-----------------------------------------------------
Fax | 702-731-5530
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JANMEJAY J PATEL
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 702-731-5510
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------