MEDICARE: RUPAL M PATEL DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1176760	TX

General Provider Information

NPI Number	:	1013236637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUPAL M PATEL DPT

Provider Business Mailing Address
First Line	:	1305 E 6TH ST APT 4
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78702-3374
Country	:	US
Telephone Number	:	512-297-2860
Fax Number	:	512-870-9471

Provider Business Practice Location Address
First Line	:	2124 E 6TH ST
Second Line	:	UNIT 106
City	:	AUSTIN
State	:	TX
Zip	:	78702-3494
Country	:	US
Telephone Number	:	512-965-7080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2010
Last Update Date	:	12/09/2013

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