Provider Demographics
NPI:1083641690
Name:PATEL, VINODKUMAR SOMABHAI (MD)
Entity Type:Individual
Prefix:DR
First Name:VINODKUMAR
Middle Name:SOMABHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1901 MEDI PARK
Mailing Address - Street 2:SUITE # 2049
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2110
Mailing Address - Country:US
Mailing Address - Phone:806-358-0433
Mailing Address - Fax:806-358-0499
Practice Address - Street 1:1901 MEDI PARK
Practice Address - Street 2:SUITE # 2049
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2110
Practice Address - Country:US
Practice Address - Phone:806-358-0433
Practice Address - Fax:806-358-0499
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG5982207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128086904Medicaid
TX128086904Medicaid
TX4067390001Medicare NSC
TX00EU48Medicare ID - Type Unspecified