Provider Demographics
NPI:1477338713
Name:PDH CORPORATION
Entity Type:Organization
Organization Name:PDH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNIST
Authorized Official - Prefix:
Authorized Official - First Name:PURAV
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-382-0890
Mailing Address - Street 1:221 W SOUTHLAKE BLVD, STE 300
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092
Mailing Address - Country:US
Mailing Address - Phone:817-796-8073
Mailing Address - Fax:817-796-8360
Practice Address - Street 1:221 W SOUTHLAKE BLVD, STE 300
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092
Practice Address - Country:US
Practice Address - Phone:817-796-8073
Practice Address - Fax:817-796-8360
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PDH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty