Provider Demographics
NPI:1518619766
Name:PRAVINA PATEL DMD PA
Entity Type:Organization
Organization Name:PRAVINA PATEL DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAVINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-781-1170
Mailing Address - Street 1:5901 HILLCROFT ST STE D6
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3332
Mailing Address - Country:US
Mailing Address - Phone:713-781-1170
Mailing Address - Fax:713-781-6659
Practice Address - Street 1:5901 HILLCROFT ST STE D6
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3332
Practice Address - Country:US
Practice Address - Phone:713-781-1170
Practice Address - Fax:713-781-6659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty