Provider Demographics
NPI:1497933147
Name:PATEL, PURVI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PURVI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 REPUBLIC DR STE 325
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-8867
Mailing Address - Country:US
Mailing Address - Phone:903-893-0298
Mailing Address - Fax:903-892-6323
Practice Address - Street 1:555 REPUBLIC DR STE 325
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-8867
Practice Address - Country:US
Practice Address - Phone:903-893-0298
Practice Address - Fax:903-892-6323
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36774103TC0700X, 103G00000X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1902975-06Medicaid
TX1902975-06Medicaid