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General NPI Number Information
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NPI Number | 1477338713
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Entity Type | Organization
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Legal Business Name | PDH CORPORATION
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 221 W SOUTHLAKE BLVD, STE 300
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City | SOUTHLAKE
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State | TX
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Zip | 76092
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Country | US
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Telephone | 817-796-8073
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Fax | 817-796-8360
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Provider Business Mailing Address
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Address Line | 221 W SOUTHLAKE BLVD, STE 300
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City | SOUTHLAKE
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State | TX
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Zip | 76092
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Country | US
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Telephone | 817-796-8073
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Fax | 817-796-8360
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Authorized Official
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Title or Position | INTERNIST
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Name | PURAV PATEL
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Credential | M.D.
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Telephone | 205-382-0890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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