Provider Demographics
NPI:1790496461
Name:SONALI VIJESH PATEL MD PLLC
Entity Type:Organization
Organization Name:SONALI VIJESH PATEL MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KHUZEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANCHWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-467-1114
Mailing Address - Street 1:876 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:PORT NECHES
Mailing Address - State:TX
Mailing Address - Zip Code:77651-3712
Mailing Address - Country:US
Mailing Address - Phone:409-729-3787
Mailing Address - Fax:
Practice Address - Street 1:876 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:PORT NECHES
Practice Address - State:TX
Practice Address - Zip Code:77651-3712
Practice Address - Country:US
Practice Address - Phone:409-729-3787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty