MEDICARE: SAMIR A. PATEL D.D.S.,PA

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	20595	TX

General Provider Information

NPI Number	:	1184066839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMIR A. PATEL D.D.S.,PA

Provider Business Mailing Address
First Line	:	401 S TENNESSEE ST
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75069-5621
Country	:	US
Telephone Number	:	972-542-3324
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 S TENNESSEE ST
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75069-5621
Country	:	US
Telephone Number	:	972-542-3324
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SAMIR PATEL
Credential	:	DDS
Telephone Number	:	972-542-3324

Provider Enumeration Date	:	07/23/2013
Last Update Date	:	07/23/2013

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