Provider Demographics
NPI:1760476964
Name:PATEL, SUNIL S (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5441 HEALTH CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-6884
Mailing Address - Country:US
Mailing Address - Phone:325-673-9806
Mailing Address - Fax:325-673-9809
Practice Address - Street 1:5441 HEALTH CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606
Practice Address - Country:US
Practice Address - Phone:325-673-9806
Practice Address - Fax:325-673-9809
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4185207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180044001OtherMEDICARE RAILROAD
TX096920603Medicaid
TX096920603Medicaid
TXG56107Medicare UPIN