Provider Demographics
NPI:1689845091
Name:PATEL, SHITAL (AUD, CCC/A)
Entity Type:Individual
Prefix:
First Name:SHITAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:AUD, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17450 ST LUKES WAY
Mailing Address - Street 2:STE 150
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-2003
Mailing Address - Country:US
Mailing Address - Phone:936-273-4437
Mailing Address - Fax:936-273-3279
Practice Address - Street 1:21216 NORTHWEST FWY
Practice Address - Street 2:SUITE 310
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1439
Practice Address - Country:US
Practice Address - Phone:281-890-6155
Practice Address - Fax:281-894-2765
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51456237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00707149Medicare PIN
TX8K5761Medicare PIN