MEDICARE: DR. NISHA PATEL B.D.S., M.D.S., M.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	122300000X	Dentist	019.032282	IL
2	1223P0700X	Prosthodontics	37070	TX

General Provider Information

NPI Number	:	1144877689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NISHA PATEL B.D.S., M.D.S., M.S.

Provider Business Mailing Address
First Line	:	1906 BARONS GLN
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4143
Country	:	US
Telephone Number	:	346-971-1194
Fax Number	:

Provider Business Practice Location Address
First Line	:	3745A WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-5227
Country	:	US
Telephone Number	:	713-244-7792
Fax Number	:

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

Provider Enumeration Date	:	08/20/2019
Last Update Date	:	03/02/2022

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