Provider Demographics
NPI:1225340144
Name:PATEL, SHITAL (MD)
Entity Type:Individual
Prefix:DR
First Name:SHITAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 NORTH LOOP W STE 42
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1445
Mailing Address - Country:US
Mailing Address - Phone:832-308-0508
Mailing Address - Fax:
Practice Address - Street 1:1801 NORTH LOOP W STE 45
Practice Address - Street 2:MEDICAL PLAZA 3
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1445
Practice Address - Country:US
Practice Address - Phone:832-308-0508
Practice Address - Fax:832-844-0707
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116022578390200000X
TXP7532207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA207Q00000XOtherFAMILY MEDICINE