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General NPI Number Information
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NPI Number | 1790012938
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Entity Type | Individual
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Provider Name | KETU PATEL D.C.
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Gender | Female
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Dates
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Enumeration Date | 11/09/2009
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Last Update Date | 11/09/2009
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Provider Practice Location Address
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Address Line | 11500 N STEMMONS FWY SUITE 145
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City | DALLAS
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State | TX
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Zip | 75229-2184
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Country | US
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Telephone | 972-241-9977
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 HEATHERBROOK DR
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City | PLANO
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State | TX
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Zip | 75074-8900
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Country | US
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Telephone | 630-842-9224
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 11189
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License Number State | TX
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