Provider Demographics
NPI:1033172473
Name:PATEL, DILIPKUMAR C (MD)
Entity Type:Individual
Prefix:DR
First Name:DILIPKUMAR
Middle Name:C
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 1:404 W. FAIRMONT PARKWAY
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77571-6308
Mailing Address - Country:US
Mailing Address - Phone:281-470-6060
Mailing Address - Fax:281-470-7284
Practice Address - Street 1:404 W. FAIRMONT PARKWAY
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-6308
Practice Address - Country:US
Practice Address - Phone:281-470-6060
Practice Address - Fax:281-470-7284
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121284702Medicaid
TX121284702Medicaid
TXG13425Medicare UPIN