Provider Demographics
NPI:1073732830
Name:PATEL, KALPESH PRAHLADBHAI (MD)
Entity Type:Individual
Prefix:
First Name:KALPESH
Middle Name:PRAHLADBHAI
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 1:211 ELMHURST
Mailing Address - Street 2:SUITE D/E
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-5982
Mailing Address - Country:US
Mailing Address - Phone:512-410-4153
Mailing Address - Fax:
Practice Address - Street 1:211 ELMHURST
Practice Address - Street 2:SUITE D/E
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-5982
Practice Address - Country:US
Practice Address - Phone:512-410-4153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7649207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB126682Medicare PIN
TXTXB126681Medicare PIN