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General NPI Number Information
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NPI Number | 1457526832
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Entity Type | Individual
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Provider Name | RAJU AMAREGOUDA PATIL M.D., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 1902 WINDSOR PL STE 102
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City | FORT WORTH
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State | TX
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Zip | 76110-1866
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Country | US
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Telephone | 682-207-1700
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Fax | 682-250-5246
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Provider Business Mailing Address
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Address Line | 1902 WINDSOR PL STE 102
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City | FORT WORTH
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State | TX
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Zip | 76110-1866
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Country | US
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Telephone | 682-207-1700
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Fax | 682-250-5246
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | R6256
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License Number State | TX
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