Provider Demographics
NPI:1376988311
Name:DIMPLE PATEL ARYA, PLLC
Entity Type:Organization
Organization Name:DIMPLE PATEL ARYA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPEUTIC OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:DIMPLE
Authorized Official - Middle Name:PATEL
Authorized Official - Last Name:ARYA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-250-9430
Mailing Address - Street 1:7909 W. GRAND PARKWAY S
Mailing Address - Street 2:SUITE 280
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407
Mailing Address - Country:US
Mailing Address - Phone:832-916-2020
Mailing Address - Fax:832-916-2020
Practice Address - Street 1:7909 W. GRAND PARKWAY S
Practice Address - Street 2:SUITE 280
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407
Practice Address - Country:US
Practice Address - Phone:832-916-2020
Practice Address - Fax:832-916-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-03
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7342TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX331711YXT4OtherMEDICARE PTAN