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General NPI Number Information
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NPI Number | 1932262433
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Entity Type | Individual
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Provider Name | SUKETU PATEL D.O.
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Gender | Male
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 3010 WILLIAMS DR SUITE 177
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City | GEORGETOWN
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State | TX
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Zip | 78628-2764
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Country | US
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Telephone | 512-868-3376
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Fax | 512-869-5868
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Provider Business Mailing Address
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Address Line | 3010 WILLIAMS DR STE 177
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City | GEORGETOWN
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State | TX
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Zip | 78628-2785
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Country | US
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Telephone | 512-868-3376
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Fax | 512-869-5868
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 229989
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | N7325
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | H0092858
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License Number State | MD
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