MEDICARE: PREM 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	207R00000X	Internal Medicine Physician	P139445	NY

General Provider Information

NPI Number	:	1912876475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PREM PATEL

Provider Business Mailing Address
First Line	:	6827 DATE PALM DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-5660
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6827 DATE PALM DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-5660
Country	:	US
Telephone Number	:	346-347-0000
Fax Number	:

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

Provider Enumeration Date	:	11/03/2025
Last Update Date	:	11/03/2025

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Directions to “ PREM PATEL ” Practice Location

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