Provider Demographics
NPI:1114211737
Name:PATEL, MILIND (RPH)
Entity Type:Individual
Prefix:MR
First Name:MILIND
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 W JEFFERSON BLVD STE 614
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-4611
Mailing Address - Country:US
Mailing Address - Phone:214-613-1111
Mailing Address - Fax:214-467-7112
Practice Address - Street 1:4444 W JEFFERSON BLVD STE 614
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-4611
Practice Address - Country:US
Practice Address - Phone:214-613-1111
Practice Address - Fax:214-467-7112
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist