Provider Demographics
NPI:1306030150
Name:PATEL, SANJAYKUMAR R (MD)
Entity Type:Individual
Prefix:
First Name:SANJAYKUMAR
Middle Name:R
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 1:3115 COLLEGE PARK DR STE 112
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4001
Mailing Address - Country:US
Mailing Address - Phone:936-230-5006
Mailing Address - Fax:281-817-5948
Practice Address - Street 1:3115 COLLEGE PARK DR STE 112
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384
Practice Address - Country:US
Practice Address - Phone:936-230-5006
Practice Address - Fax:281-817-5948
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234664207RC0000X
TXM9571207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J21AOtherGROUP MEDICARE NUMBER
TX00J21AOtherGROUP MEDICARE NUMBER