Provider Demographics
NPI:1548742893
Name:PATEL, NIRAV
Entity Type:Individual
Prefix:MR
First Name:NIRAV
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 1:5201 S COOPER ST STE 117
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5964
Mailing Address - Country:US
Mailing Address - Phone:817-419-2688
Mailing Address - Fax:817-419-2690
Practice Address - Street 1:5201 S COOPER ST STE 117
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5964
Practice Address - Country:US
Practice Address - Phone:817-419-2688
Practice Address - Fax:817-419-2690
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX471911835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist