Provider Demographics
NPI:1497005615
Name:PATEL, ANKUR B (RPH)
Entity Type:Individual
Prefix:DR
First Name:ANKUR
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 BROADWAY ST STE 203
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4117
Mailing Address - Country:US
Mailing Address - Phone:281-506-8734
Mailing Address - Fax:
Practice Address - Street 1:4205 BROADWAY ST STE 203
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4117
Practice Address - Country:US
Practice Address - Phone:281-506-8734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67180183500000X
TX50683183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist