Provider Demographics
NPI:1730297581
Name:PATEL, RAJSHEKHAR R (MD)
Entity Type:Individual
Prefix:
First Name:RAJSHEKHAR
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAJ
Other - Middle Name:R
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 5171
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79704-5171
Mailing Address - Country:US
Mailing Address - Phone:432-697-0100
Mailing Address - Fax:432-694-4447
Practice Address - Street 1:4214 ANDREWS HWY STE 100B
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-4872
Practice Address - Country:US
Practice Address - Phone:432-697-0100
Practice Address - Fax:432-694-4447
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6301207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134887203Medicaid
TXC20277Medicare UPIN
TX134887203Medicaid
TX1730297581Medicare PIN