Provider Demographics
NPI:1497752869
Name:PATEL, VIPOOL R (MD)
Entity Type:Individual
Prefix:DR
First Name:VIPOOL
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4301 N MESA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1121
Mailing Address - Country:US
Mailing Address - Phone:915-532-6767
Mailing Address - Fax:915-532-4023
Practice Address - Street 1:4301 N MESA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1121
Practice Address - Country:US
Practice Address - Phone:915-532-6767
Practice Address - Fax:915-532-4023
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK0981207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK0981OtherTEXAS MEDICAL LICENSE
G14643Medicare UPIN