=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467510990
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VASISHTA M PATEL M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2006
-----------------------------------------------------
Last Update Date | 04/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2424 W HOLCOMBE BLVD STE 101
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-1933
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-540-0053
-----------------------------------------------------
Fax | 281-540-0057
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2424 W HOLCOMBE BLVD STE 101
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-1933
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-540-0053
-----------------------------------------------------
Fax | 281-540-0057
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 204R00000X
-----------------------------------------------------
Taxonomy Name | Electrodiagnostic Medicine Physician
-----------------------------------------------------
License Number | G4190
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | G4190
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | G4190
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------