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General NPI Number Information
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NPI Number | 1528219201
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Entity Type | Organization
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Legal Business Name | SANJAY B. PATEL, MD P.A.
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Dates
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Enumeration Date | 10/01/2008
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Last Update Date | 05/28/2009
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Provider Practice Location Address
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Address Line | 1650 W COLLEGE ST BOX 57
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City | GRAPEVINE
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State | TX
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Zip | 76051-3565
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Country | US
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Telephone | 214-770-1182
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Fax | 972-608-9868
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Provider Business Mailing Address
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Address Line | 3800 EDGESTONE DR
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City | PLANO
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State | TX
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Zip | 75093-7966
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Country | US
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Telephone | 214-770-1182
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Fax | 972-608-9868
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SANJAY BALU PATEL
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Credential | M.D.
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Telephone | 214-770-1182
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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 | L2536
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License Number State | TX
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