Provider Demographics
NPI:1063018935
Name:PATEL, ANISH ANUP (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:ANISH
Middle Name:ANUP
Last Name:PATEL
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9403 SUMMER SUN LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2889
Mailing Address - Country:US
Mailing Address - Phone:832-275-9871
Mailing Address - Fax:
Practice Address - Street 1:9403 SUMMER SUN LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2889
Practice Address - Country:US
Practice Address - Phone:832-275-9871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020099363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily