Provider Demographics
NPI:1346553120
Name:PATEL, AMIT M (MD)
Entity Type:Individual
Prefix:
First Name:AMIT
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8525 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-8023
Mailing Address - Country:US
Mailing Address - Phone:409-729-2262
Mailing Address - Fax:409-729-2449
Practice Address - Street 1:8525 9TH AVE
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-8023
Practice Address - Country:US
Practice Address - Phone:409-729-2262
Practice Address - Fax:409-729-2449
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA122941207N00000X
TXQ8995207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ8995OtherTEXAS MEDICAL LIC