MEDICARE: DR. RAHUL PATRI 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	207RC0000X	Cardiovascular Disease Physician	P8975	TX

General Provider Information

NPI Number	:	1578720850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAHUL PATRI MD

Provider Business Mailing Address
First Line	:	3345 PLAZA 10 DR STE E
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77707-2553
Country	:	US
Telephone Number	:	409-838-2626
Fax Number	:	409-838-1980

Provider Business Practice Location Address
First Line	:	3345 PLAZA 10 DR STE E
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77707-2553
Country	:	US
Telephone Number	:	409-838-2626
Fax Number	:	409-838-1980

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

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	09/30/2022

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Directions to “ DR. RAHUL PATRI MD” Practice Location

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