Provider Demographics
NPI:1245611367
Name:PATEL, MAHEEN
Entity Type:Individual
Prefix:
First Name:MAHEEN
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 E PRESIDENT GEORGE BUSH HWY
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3561
Mailing Address - Country:US
Mailing Address - Phone:469-204-2021
Mailing Address - Fax:469-204-2036
Practice Address - Street 1:2831 E PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3561
Practice Address - Country:US
Practice Address - Phone:469-204-2021
Practice Address - Fax:469-204-2036
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR4123207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program