Provider Demographics
NPI:1235149600
Name:GOLLA, SHEETAL PATEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEETAL
Middle Name:PATEL
Last Name:GOLLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:411 PARK GROVE LN SUITE 310
Mailing Address - Street 2:APT # 12104
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6175
Mailing Address - Country:US
Mailing Address - Phone:713-464-9100
Mailing Address - Fax:713-468-6183
Practice Address - Street 1:3131 MEMORIAL CT
Practice Address - Street 2:APT # 12104
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-6175
Practice Address - Country:US
Practice Address - Phone:312-933-2392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP2050207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX338341601Medicaid