Provider Demographics
NPI:1477948172
Name:PATEL, KRUTI R (DO)
Entity Type:Individual
Prefix:DR
First Name:KRUTI
Middle Name:R
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 N HIGHLAND AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7383
Mailing Address - Country:US
Mailing Address - Phone:903-231-7962
Mailing Address - Fax:903-868-2317
Practice Address - Street 1:425 N HIGHLAND AVE STE 130
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7383
Practice Address - Country:US
Practice Address - Phone:903-868-7962
Practice Address - Fax:903-868-2317
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS9202207RG0100X
OH390200000X
OH012456207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty