Provider Demographics
NPI:1790995967
Name:PATEL, YOGI V (RPH)
Entity Type:Individual
Prefix:
First Name:YOGI
Middle Name:V
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 FM 71
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:TX
Mailing Address - Zip Code:75428-8052
Mailing Address - Country:US
Mailing Address - Phone:903-456-4960
Mailing Address - Fax:903-300-3701
Practice Address - Street 1:102 E DALLAS AVE
Practice Address - Street 2:
Practice Address - City:COOPER
Practice Address - State:TX
Practice Address - Zip Code:75432-2043
Practice Address - Country:US
Practice Address - Phone:903-395-2161
Practice Address - Fax:903-300-3701
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28813183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist