Provider Demographics
NPI:1376838912
Name:PATEL, BRINA MATHEW (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:BRINA
Middle Name:MATHEW
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3702 RANCH ROAD 620 S
Mailing Address - Street 2:T-1812
Mailing Address - City:BEE CAVE
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6304
Mailing Address - Country:US
Mailing Address - Phone:512-651-0095
Mailing Address - Fax:512-651-0095
Practice Address - Street 1:3702 RANCH ROAD 620 S
Practice Address - Street 2:T-1812
Practice Address - City:BEE CAVE
Practice Address - State:TX
Practice Address - Zip Code:78738-6304
Practice Address - Country:US
Practice Address - Phone:512-651-0095
Practice Address - Fax:512-651-0095
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-11
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40161183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist