Provider Demographics
NPI:1629112834
Name:PATEL, NITIN K (OD)
Entity Type:Individual
Prefix:DR
First Name:NITIN
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 VALLEY VIEW LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-4972
Mailing Address - Country:US
Mailing Address - Phone:972-991-2020
Mailing Address - Fax:
Practice Address - Street 1:5100 BELT LINE RD
Practice Address - Street 2:850
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7559
Practice Address - Country:US
Practice Address - Phone:972-991-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4696T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist