Provider Demographics
NPI:1346693769
Name:PATEL, PRITESH (OD)
Entity Type:Individual
Prefix:
First Name:PRITESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10740 S. MAY AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-5152
Mailing Address - Country:US
Mailing Address - Phone:405-608-3055
Mailing Address - Fax:405-607-1757
Practice Address - Street 1:10740 S. MAY AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-5152
Practice Address - Country:US
Practice Address - Phone:405-608-3055
Practice Address - Fax:405-607-1757
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-20
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK2902152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist