Provider Demographics
NPI:1114239571
Name:PATEL, PIKUL B (MD)
Entity Type:Individual
Prefix:DR
First Name:PIKUL
Middle Name:B
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 1:1620 E RIVERSIDE DR
Mailing Address - Street 2:APT 3079
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-1008
Mailing Address - Country:US
Mailing Address - Phone:262-939-4930
Mailing Address - Fax:
Practice Address - Street 1:6300 LA CALMA DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3825
Practice Address - Country:US
Practice Address - Phone:512-452-8533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6496207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine