Provider Demographics
NPI:1033700604
Name:PATEL, KIRANBEN NIRMAL
Entity Type:Individual
Prefix:
First Name:KIRANBEN
Middle Name:NIRMAL
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NOBLE CT
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4237
Mailing Address - Country:US
Mailing Address - Phone:469-449-3668
Mailing Address - Fax:
Practice Address - Street 1:3005 E RENNER RD STE 120
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3570
Practice Address - Country:US
Practice Address - Phone:214-324-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist