MEDICARE: MEERA VIJAY PATEL DDS

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	390200000X	Student in an Organized Health Care Education/Training Program
2	1223G0001X	General Practice Dentistry	37761	TX

General Provider Information

NPI Number	:	1528637576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEERA VIJAY PATEL DDS

Provider Business Mailing Address
First Line	:	5819 WATERWALK CT
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-7360
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1436 W GRAY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-4927
Country	:	US
Telephone Number	:	713-521-3131
Fax Number	:

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

Provider Enumeration Date	:	06/23/2021
Last Update Date	:	08/19/2021

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Directions to “ MEERA VIJAY PATEL DDS” Practice Location

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