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General NPI Number Information
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NPI Number | 1417201971
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Entity Type | Organization
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Legal Business Name | JAI V PATEL DDS PA
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 11/06/2012
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Provider Practice Location Address
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Address Line | 3000 SILVERLAKE VILLAGE DR STE 100
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City | PEARLAND
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State | TX
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Zip | 77584-8422
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Country | US
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Telephone | 713-436-9959
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Fax | 713-436-9968
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Provider Business Mailing Address
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Address Line | 3000 SILVERLAKE VILLAGE DR STE 100
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City | PEARLAND
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State | TX
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Zip | 77584-8422
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Country | US
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Telephone | 713-436-9959
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Fax | 713-436-9968
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAI VALLABH PATEL
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Credential | D.D.S.
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Telephone | 713-436-9959
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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 | 20508
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License Number State | TX
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