Provider Demographics
NPI:1669676136
Name:PATEL, SNEHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SNEHA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 E BROAD ST STE 318
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6413
Mailing Address - Country:US
Mailing Address - Phone:817-779-3178
Mailing Address - Fax:844-292-1460
Practice Address - Street 1:2800 E BROAD ST STE 318
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6413
Practice Address - Country:US
Practice Address - Phone:817-779-3178
Practice Address - Fax:844-292-1460
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2235207R00000X, 207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CC816OtherBCBS OF TX
TX8L15595Medicare PIN