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General NPI Number Information
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NPI Number | 1700641826
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Entity Type | Individual
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Provider Name | SIMONE PATEL PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/19/2024
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 2028 E BEN WHITE BLVD STE 240-4949
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City | AUSTIN
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State | TX
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Zip | 78741-6966
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Country | US
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Telephone | 512-655-3578
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Fax |
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Provider Business Mailing Address
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Address Line | 2346 TIMBERLAKE CIR
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City | ALLEN
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State | TX
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Zip | 75013-5835
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Country | US
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Telephone | 214-592-5869
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA17627
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License Number State | TX
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