Provider Demographics
NPI:1275525818
Name:PATEL, JIGNESH DEVKARANBHAI (MD)
Entity Type:Individual
Prefix:
First Name:JIGNESH
Middle Name:DEVKARANBHAI
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 1:11026 VISTA DEL SOL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-4314
Mailing Address - Country:US
Mailing Address - Phone:915-593-5444
Mailing Address - Fax:915-594-7147
Practice Address - Street 1:11026 VISTA DEL SOL
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-4314
Practice Address - Country:US
Practice Address - Phone:915-593-5444
Practice Address - Fax:915-594-7147
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7096208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX169581901Medicaid
TX169581901Medicaid
I07080Medicare UPIN