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General NPI Number Information
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NPI Number | 1508436734
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Entity Type | Individual
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Provider Name | KEYUR PATEL DMD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 10910 MARBACH RD STE 107
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City | SAN ANTONIO
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State | TX
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Zip | 78245-2089
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Country | US
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Telephone | 210-742-2444
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Fax |
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Provider Business Mailing Address
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Address Line | 262 WINDSOR DR
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City | BARTLETT
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State | IL
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Zip | 60103-5181
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Country | US
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Telephone | 609-721-3844
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 37380
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License Number State | TX
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