Provider Demographics
NPI:1588605703
Name:PATEL, YESROON Y (MD, FAAP)
Entity Type:Individual
Prefix:DR
First Name:YESROON
Middle Name:Y
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5460 PAREDES LINE RD
Mailing Address - Street 2:SUITE #206-328
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-9740
Mailing Address - Country:US
Mailing Address - Phone:956-350-0010
Mailing Address - Fax:956-350-0002
Practice Address - Street 1:100 E ALTON GLOOR BLVD
Practice Address - Street 2:STE# 120
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3354
Practice Address - Country:US
Practice Address - Phone:956-350-0010
Practice Address - Fax:956-350-0002
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4186208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178566901Medicaid