Provider Demographics
NPI:1538309562
Name:PATEL, SANDRA PATRICIA (RPT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:PATRICIA
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25615 COREY COVE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2911
Mailing Address - Country:US
Mailing Address - Phone:832-265-6002
Mailing Address - Fax:281-303-5295
Practice Address - Street 1:25615 COREY COVE LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2911
Practice Address - Country:US
Practice Address - Phone:832-265-6002
Practice Address - Fax:281-303-5295
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11034302251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics