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NPI Code Detail

MEDICARE: KOMAL PATEL

MEDICARE: KOMAL PATEL
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
1152W00000XOptometristOPT-002925AZ
2152W00000XOptometrist3146OK

General Provider Information

NPI Number : 1306417308
Entity Type Code : Individual
Provider Name (Legal Business Name) : KOMAL PATEL
Provider Business Mailing Address
First Line : 2601 E ROOSEVELT ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4973
Country : US
Telephone Number : 602-344-5011
Fax Number :
Provider Business Practice Location Address
First Line : 2601 E ROOSEVELT ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4973
Country : US
Telephone Number : 602-344-5011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2021
Last Update Date : 03/21/2026

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Directions to “ KOMAL PATEL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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