Provider Demographics
NPI:1174962526
Name:PATEL, MINAL D (DPT)
Entity type:Individual
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First Name:MINAL
Middle Name:D
Last Name:PATEL
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Gender:F
Credentials:DPT
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Mailing Address - Street 1:335 ROSELANE ST NW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7902
Mailing Address - Country:US
Mailing Address - Phone:470-259-5226
Mailing Address - Fax:267-321-2044
Practice Address - Street 1:3710 CENTER ST
Practice Address - Street 2:SUITE 102
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-6104
Practice Address - Country:US
Practice Address - Phone:281-476-5800
Practice Address - Fax:281-476-5801
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2016-03-01
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Provider Licenses
StateLicense IDTaxonomies
TX3113700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX376795ZS1KMedicare PIN
TX470445Medicare PIN
TX676519Medicare Oscar/Certification