Provider Demographics
NPI:1225060064
Name:PATEL, BHAGWAT P (MD,)
Entity Type:Individual
Prefix:
First Name:BHAGWAT
Middle Name:P
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 1:1250 CREEK WAY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3382
Mailing Address - Country:US
Mailing Address - Phone:281-494-1420
Mailing Address - Fax:281-494-1471
Practice Address - Street 1:1250 CREEK WAY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3382
Practice Address - Country:US
Practice Address - Phone:281-494-1420
Practice Address - Fax:281-494-1471
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8158207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXY14131Medicare UPIN
8C1059Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID