MEDICARE: MADRI PATEL PMHNP-BC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1871453159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADRI PATEL PMHNP-BC

Provider Business Mailing Address
First Line	:	108 REBEL RED CV
Second Line	:
City	:	LIBERTY HILL
State	:	TX
Zip	:	78642-2130
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 REBEL RED CV
Second Line	:
City	:	LIBERTY HILL
State	:	TX
Zip	:	78642-2130
Country	:	US
Telephone Number	:	346-400-6292
Fax Number	:

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

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	11/17/2025

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