MEDICARE: DR. NEEL HARSHAD PATEL D.D.S.

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	1223G0001X	General Practice Dentistry	0024764	TX

General Provider Information

NPI Number	:	1114232667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEEL HARSHAD PATEL D.D.S.

Provider Business Mailing Address
First Line	:	3825 YUCCA AVE
Second Line	:	STE 101
City	:	FORT WORTH
State	:	TX
Zip	:	76111-6067
Country	:	US
Telephone Number	:	817-834-2600
Fax Number	:

Provider Business Practice Location Address
First Line	:	3825 YUCCA AVE STE 101
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76111-6067
Country	:	US
Telephone Number	:	817-831-9300
Fax Number	:

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

Provider Enumeration Date	:	08/09/2010
Last Update Date	:	09/26/2014

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