Provider Demographics
NPI:1821030743
Name:PATEL, MRUGESH PRAHLAD (MD)
Entity Type:Individual
Prefix:DR
First Name:MRUGESH
Middle Name:PRAHLAD
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:997-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:1615 HOSPITAL PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-5934
Practice Address - Country:US
Practice Address - Phone:817-359-9000
Practice Address - Fax:817-359-9062
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2022-11-29
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Provider Licenses
StateLicense IDTaxonomies
TXK9865207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148530201Medicaid
TX148530205Medicaid
TX8R1521OtherBLUE CROSS OF TEXAS