Provider Demographics
NPI:1164022752
Name:PATEL, BHAVIKA (PHD)
Entity Type:Individual
Prefix:
First Name:BHAVIKA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 AMERICAN PACIFIC DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7401
Mailing Address - Country:US
Mailing Address - Phone:702-498-5716
Mailing Address - Fax:
Practice Address - Street 1:1401 AMERICAN PACIFIC DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7401
Practice Address - Country:US
Practice Address - Phone:702-564-2960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-31
Last Update Date:2022-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17705183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist