Provider Demographics
NPI:1578547881
Name:PATEL, GHANSHYAM M (MD)
Entity Type:Individual
Prefix:DR
First Name:GHANSHYAM
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 17895
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-7895
Mailing Address - Country:US
Mailing Address - Phone:281-240-0950
Mailing Address - Fax:281-240-0970
Practice Address - Street 1:12002 S HIGHWAY 6 STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-5757
Practice Address - Country:US
Practice Address - Phone:281-240-0950
Practice Address - Fax:281-240-0970
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL7095207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00228805OtherRAILROAD MEDICARE
TX162782701Medicaid
TX00974VMedicare PIN