Provider Demographics
NPI:1225376346
Name:PATEL, HENNA (DO)
Entity Type:Individual
Prefix:DR
First Name:HENNA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 153969
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75015-3969
Mailing Address - Country:US
Mailing Address - Phone:817-385-9799
Mailing Address - Fax:817-385-9881
Practice Address - Street 1:1115 E ARKANSAS LN
Practice Address - Street 2:SUITE B
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-6415
Practice Address - Country:US
Practice Address - Phone:817-385-9799
Practice Address - Fax:817-385-9881
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5298208000000X, 2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics