Provider Demographics
NPI:1023219623
Name:PATEL, SHITEL DINESHBHAI (MD)
Entity Type:Individual
Prefix:
First Name:SHITEL
Middle Name:DINESHBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 GENESIS BLVD # B
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-1636
Mailing Address - Country:US
Mailing Address - Phone:832-835-1131
Mailing Address - Fax:832-918-3223
Practice Address - Street 1:210 GENESIS BLVD # B
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-1636
Practice Address - Country:US
Practice Address - Phone:832-835-1131
Practice Address - Fax:832-918-3223
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP78322086S0122X
TXBP10042294208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty