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General NPI Number Information
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NPI Number | 1942549696
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Entity Type | Individual
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Provider Name | PURAV PATEL DMD
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Gender | Male
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Dates
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Enumeration Date | 01/31/2013
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Last Update Date | 12/07/2015
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Provider Practice Location Address
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Address Line | 2203 W 35TH ST BUILDING 727
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City | AUSTIN
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State | TX
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Zip | 78703-1203
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Country | US
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Telephone | 512-454-4731
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Fax |
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Provider Business Mailing Address
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Address Line | 811 E 11TH ST APT 229
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City | AUSTIN
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State | TX
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Zip | 78702-1930
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Country | US
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Telephone | 732-318-8876
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 29778
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License Number State | TX
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