MEDICARE: PAYAL M. PATEL DMD

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	1223G0001X	General Practice Dentistry	40483	TX

General Provider Information

NPI Number	:	1982393088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAYAL M. PATEL DMD

Provider Business Mailing Address
First Line	:	466 N MAIN ST
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-4518
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	466 N MAIN ST
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-4518
Country	:	US
Telephone Number	:	817-741-4455
Fax Number	:

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

Provider Enumeration Date	:	05/04/2023
Last Update Date	:	05/20/2026

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