Provider Demographics
NPI:1437874773
Name:PATEL, HETAL MITESH (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:HETAL
Middle Name:MITESH
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N GALLOWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-3419
Mailing Address - Country:US
Mailing Address - Phone:972-288-4485
Mailing Address - Fax:972-288-3091
Practice Address - Street 1:500 N GALLOWAY AVE
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-3419
Practice Address - Country:US
Practice Address - Phone:972-288-4485
Practice Address - Fax:972-288-3091
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44882183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist