Provider Demographics
NPI:1710987995
Name:PATEL, VIPULKUMAR G (M D)
Entity Type:Individual
Prefix:
First Name:VIPULKUMAR
Middle Name:G
Last Name:PATEL
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58233
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8233
Mailing Address - Country:US
Mailing Address - Phone:281-534-8800
Mailing Address - Fax:281-534-8826
Practice Address - Street 1:3828 HUGHES CT
Practice Address - Street 2:SUITE 105
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-6244
Practice Address - Country:US
Practice Address - Phone:281-534-8800
Practice Address - Fax:281-534-8826
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0496207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1542474-01Medicaid
TX3028424OtherAETNA
TX10686213OtherPPONEXT
TX2016422OtherFIRST HEALTH
TX9501450OtherCIGNA
TX00867FOtherBLUE CROSS BLUE SHIELD
TX1542474-02Medicaid
TX8A0619Medicare ID - Type UnspecifiedHARRIS COUNTY
TX9501450OtherCIGNA
TX3028424OtherAETNA
TX110243858Medicare ID - Type UnspecifiedRAILROAD MEDICARE