MEDICARE: PARESHKUMAR M PATEL DO

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	207Q00000X	Family Medicine Physician	K5177	TX

General Provider Information

NPI Number	:	1134298581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARESHKUMAR M PATEL DO

Provider Business Mailing Address
First Line	:	P.O. BOX 961205
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76161-1205
Country	:	US
Telephone Number	:	817-740-8400
Fax Number	:	817-378-3699

Provider Business Practice Location Address
First Line	:	3645 WESTERN CENTER BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-1936
Country	:	US
Telephone Number	:	817-232-9767
Fax Number	:	817-232-9102

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	12/16/2016

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Directions to “ PARESHKUMAR M PATEL DO” Practice Location

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