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General NPI Number Information
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NPI Number | 1609317262
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Entity Type | Organization
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Legal Business Name | SOUTH DALLAS INFECTIOUS DISEASES PLLC
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Dates
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Enumeration Date | 03/15/2017
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 951 YORK DR SUITE 102
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City | DESOTO
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State | TX
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Zip | 75115-2052
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Country | US
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Telephone | 469-850-2697
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Fax |
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Provider Business Mailing Address
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Address Line | 13567 LEESON LN
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City | FRISCO
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State | TX
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Zip | 75035-0806
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Country | US
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Telephone | 972-679-6722
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. RONAK JASHVANTRAY PATEL
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Credential | M.D.
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Telephone | 972-679-6722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | P3055
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License Number State | TX
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