Provider Demographics
NPI:1407452527
Name:PATEL, RIDHAM HASMUKHBHAI (PHARMD)
Entity Type:Individual
Prefix:
First Name:RIDHAM
Middle Name:HASMUKHBHAI
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 1:8009 GRAYSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-3825
Mailing Address - Country:US
Mailing Address - Phone:214-476-0292
Mailing Address - Fax:
Practice Address - Street 1:1501 BUCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5304
Practice Address - Country:US
Practice Address - Phone:214-476-0292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-06
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59838183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist