=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710782339
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PARTH PATEL DMD, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2025
-----------------------------------------------------
Last Update Date | 02/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2960 FM 1460 STE 104
-----------------------------------------------------
City | GEORGETOWN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78626-3273
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 737-245-6866
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 44 EAST AVE UNIT 3702
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78701-1191
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-567-3830
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DR.
-----------------------------------------------------
Name | PARTH PATEL
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 315-567-3830
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------