Provider Demographics
NPI:1245230622
Name:PATEL, RAJESH JANAKRAY (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:JANAKRAY
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:PO BOX 3942
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79760-3942
Mailing Address - Country:US
Mailing Address - Phone:432-580-8000
Mailing Address - Fax:432-332-9677
Practice Address - Street 1:601 GOLDER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4412
Practice Address - Country:US
Practice Address - Phone:432-580-8000
Practice Address - Fax:432-332-9677
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9782207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1364622-06Medicaid
TX1364622-06Medicaid
TX8F8724Medicare PIN