Provider Demographics
NPI:1235636176
Name:PATEL, VISHRUTI Y (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:VISHRUTI
Middle Name:Y
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 RUSTIC CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-1227
Mailing Address - Country:US
Mailing Address - Phone:682-557-9584
Mailing Address - Fax:
Practice Address - Street 1:4435 GUS THOMASSON RD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2231
Practice Address - Country:US
Practice Address - Phone:972-270-2074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-08
Last Update Date:2018-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist