Provider Demographics
NPI:1417976523
Name:GHANSHYAM M. PATEL MDPA
Entity Type:Organization
Organization Name:GHANSHYAM M. PATEL MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GHANSHYAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-240-0950
Mailing Address - Street 1:PO BOX 17895
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-7895
Mailing Address - Country:US
Mailing Address - Phone:281-240-0950
Mailing Address - Fax:281-240-0970
Practice Address - Street 1:1111 HIGHWAY 6
Practice Address - Street 2:SUITE # 190
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4914
Practice Address - Country:US
Practice Address - Phone:281-240-0950
Practice Address - Fax:281-240-0970
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GHANSHYAM M PATEL MDPA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-19
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7095207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00228805OtherRAILROAD MEDICARE
TX00974VMedicare PIN
TXP00228805OtherRAILROAD MEDICARE