MEDICARE: DR. SHEETAL PATEL GOLLA M.D.

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	207RN0300X	Nephrology Physician	P2050	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235149600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEETAL PATEL GOLLA M.D.

Provider Business Mailing Address
First Line	:	411 PARK GROVE LN SUITE 310
Second Line	:	APT # 12104
City	:	KATY
State	:	TX
Zip	:	77450-6175
Country	:	US
Telephone Number	:	713-464-9100
Fax Number	:	713-468-6183

Provider Business Practice Location Address
First Line	:	3131 MEMORIAL CT
Second Line	:	APT # 12104
City	:	HOUSTON
State	:	TX
Zip	:	77007-6175
Country	:	US
Telephone Number	:	312-933-2392
Fax Number	:

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	01/17/2020

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