MEDICARE: DR. GHANSHYAM M PATEL MD

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	207W00000X	Ophthalmology Physician	L7095	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00228805	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1578547881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GHANSHYAM M PATEL MD

Provider Business Mailing Address
First Line	:	PO BOX 17895
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77496-7895
Country	:	US
Telephone Number	:	281-240-0950
Fax Number	:	281-240-0970

Provider Business Practice Location Address
First Line	:	12002 S HIGHWAY 6 STE 100
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77498-5757
Country	:	US
Telephone Number	:	281-240-0950
Fax Number	:	281-240-0970

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	09/15/2022

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