Provider Demographics
NPI:1083634356
Name:PATEL, VIKAS (MD)
Entity Type:Individual
Prefix:DR
First Name:VIKAS
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 1:100 HILLCREST MEDICAL BLVD
Mailing Address - Street 2:HOSPITALIST/TRAUMA OFFICE
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8897
Mailing Address - Country:US
Mailing Address - Phone:254-202-5370
Mailing Address - Fax:
Practice Address - Street 1:100 HILLCREST MEDICAL BLVD
Practice Address - Street 2:HOSPITALIST/TRAUMA OFFICE
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8897
Practice Address - Country:US
Practice Address - Phone:254-202-5370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2007207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G3567Medicare ID - Type Unspecified
TXI02574Medicare UPIN