MEDICARE: AMITBHAI 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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1871073981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMITBHAI PATEL

Provider Business Mailing Address
First Line	:	9757 AMARANTH DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-3238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4240 GOLDEN TRIANGLE BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-4843
Country	:	US
Telephone Number	:	817-380-6400
Fax Number	:

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

Provider Enumeration Date	:	08/17/2018
Last Update Date	:	08/17/2018

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Directions to “ AMITBHAI PATEL ” Practice Location

Language	Start Address	Practice Location

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