Provider Demographics
NPI:1063830933
Name:PATEL, MAUNIK (MD)
Entity Type:Individual
Prefix:DR
First Name:MAUNIK
Middle Name:
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 1:5925 ALMEDA RD
Mailing Address - Street 2:#11503
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7602
Mailing Address - Country:US
Mailing Address - Phone:859-396-6188
Mailing Address - Fax:
Practice Address - Street 1:5925 ALMEDA RD
Practice Address - Street 2:#11503
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7602
Practice Address - Country:US
Practice Address - Phone:859-396-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ5244208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program