Provider Demographics
NPI:1689692477
Name:PATOLIA, SHREEKANT N (MD)
Entity Type:Individual
Prefix:
First Name:SHREEKANT
Middle Name:N
Last Name:PATOLIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1315 ST JOSEPH PKWY
Mailing Address - Street 2:#1200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002
Mailing Address - Country:US
Mailing Address - Phone:713-756-8707
Mailing Address - Fax:713-756-8353
Practice Address - Street 1:1315 ST JOSEPH PKWY
Practice Address - Street 2:#1200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002
Practice Address - Country:US
Practice Address - Phone:713-756-8707
Practice Address - Fax:713-756-8353
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK3385207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G25802Medicare UPIN
TX0089BFMedicare ID - Type Unspecified