Provider Demographics
NPI:1518397363
Name:PATEL, KALPESH
Entity Type:Individual
Prefix:
First Name:KALPESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 HALL JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-8735
Mailing Address - Country:US
Mailing Address - Phone:817-410-8808
Mailing Address - Fax:817-410-1512
Practice Address - Street 1:2051 HALL JOHNSON RD
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-8735
Practice Address - Country:US
Practice Address - Phone:817-410-8808
Practice Address - Fax:817-410-1512
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist