MEDICARE: MR. MILAN R PATEL BOARD ELIGIBLE PO

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	222Z00000X	Orthotist	1661	TX
2	224P00000X	Prosthetist	1661	TX

General Provider Information

NPI Number	:	1871941393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MILAN R PATEL BOARD ELIGIBLE PO

Provider Business Mailing Address
First Line	:	2525 W BELLFORT AVE STE 150
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-5099
Country	:	US
Telephone Number	:	713-349-8117
Fax Number	:	409-763-6863

Provider Business Practice Location Address
First Line	:	2525 W BELLFORT AVE STE 150
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-5099
Country	:	US
Telephone Number	:	713-349-8117
Fax Number	:	713-349-8433

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

Provider Enumeration Date	:	05/25/2016
Last Update Date	:	12/23/2021

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