Provider Demographics
NPI:1174766521
Name:PATEL, NINA R (DO)
Entity type:Individual
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First Name:NINA
Middle Name:R
Last Name:PATEL
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Gender:F
Credentials:DO
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Mailing Address - Street 1:10900 STONELAKE BLVD
Mailing Address - Street 2:SUITE A-250
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-795-5100
Mailing Address - Fax:512-795-5122
Practice Address - Street 1:10900 STONELAKE BLVD
Practice Address - Street 2:SUITE A-250
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759
Practice Address - Country:US
Practice Address - Phone:512-795-5100
Practice Address - Fax:512-795-5122
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2012-03-08
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Provider Licenses
StateLicense IDTaxonomies
TXL90542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH94936Medicare UPIN
TXTXB133295Medicare PIN