Provider Demographics
NPI:1689638421
Name:PATEL, NILESH DEVABHAI (MD)
Entity Type:Individual
Prefix:
First Name:NILESH
Middle Name:DEVABHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2215 NASHVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1105
Mailing Address - Country:US
Mailing Address - Phone:806-725-5844
Mailing Address - Fax:806-723-6532
Practice Address - Street 1:9812 SLIDE RD
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-5781
Practice Address - Country:US
Practice Address - Phone:806-725-9900
Practice Address - Fax:806-798-7567
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2020-09-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ9777207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139233416Medicaid
TX8571M8Medicare PIN
TX139233416Medicaid