Provider Demographics
NPI:1609471614
Name:PATEL, PRIYA SAPAN
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:SAPAN
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 PIPERS CREEK CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4673
Mailing Address - Country:US
Mailing Address - Phone:248-842-3321
Mailing Address - Fax:
Practice Address - Street 1:5510 W OREM DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77085-1250
Practice Address - Country:US
Practice Address - Phone:713-723-1118
Practice Address - Fax:713-723-5992
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24543333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy