Provider Demographics
NPI:1487819744
Name:PATEL, SNEHALKUMAR BALDEVBHAI (MD)
Entity Type:Individual
Prefix:
First Name:SNEHALKUMAR
Middle Name:BALDEVBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N STATE OF FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6034
Mailing Address - Country:US
Mailing Address - Phone:423-431-7047
Mailing Address - Fax:423-979-0569
Practice Address - Street 1:111 DALLAS ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1201
Practice Address - Country:US
Practice Address - Phone:210-297-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN475822084P0800X
VA01012516962084P0800X
TXR57922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1487819744Medicaid
TN1530269Medicaid
TN4352232OtherMAGELLAN
P01348615OtherRR MEDICARE
TN1530269Medicaid
VAVVD970AMedicare PIN
TN103I262971Medicare PIN
VAC09112Medicare UPIN