Provider Demographics
NPI:1215015292
Name:SANDEEP B. PATEL, D.D.S., P.A.
Entity Type:Organization
Organization Name:SANDEEP B. PATEL, D.D.S., P.A.
Other - Org Name:ONION CREEK FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-233-6200
Mailing Address - Street 1:11215 S. IH-35
Mailing Address - Street 2:SUITE#116
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78747
Mailing Address - Country:US
Mailing Address - Phone:512-233-6200
Mailing Address - Fax:512-233-6201
Practice Address - Street 1:411 BRAZOS ST
Practice Address - Street 2:UNIT #206
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-3698
Practice Address - Country:US
Practice Address - Phone:512-233-6200
Practice Address - Fax:512-233-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21274122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty