Provider Demographics
NPI:1942511290
Name:PATEL, NEIL N (MD)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:N
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1545 E SOUTHLAKE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6465
Mailing Address - Country:US
Mailing Address - Phone:817-442-9300
Mailing Address - Fax:817-416-0108
Practice Address - Street 1:1545 E SOUTHLAKE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6465
Practice Address - Country:US
Practice Address - Phone:817-442-9300
Practice Address - Fax:817-416-0108
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301096984207X00000X
CAA135268207X00000X
TXQ8598207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX518927ZSTTMedicare PIN
TX518927ZSTXMedicare PIN
TX518927ZSTUMedicare PIN