Provider Demographics
NPI:1619591757
Name:PATEL, WOURNICABEN KARTIK
Entity Type:Individual
Prefix:
First Name:WOURNICABEN
Middle Name:KARTIK
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 1:7406 SUGAR MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-8409
Mailing Address - Country:US
Mailing Address - Phone:361-585-6386
Mailing Address - Fax:
Practice Address - Street 1:7406 SUGAR MAPLE DR
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-8409
Practice Address - Country:US
Practice Address - Phone:361-585-6386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX984214163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse