Provider Demographics
NPI:1821244286
Name:PATEL, SANJAY H (DO)
Entity Type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:H
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4001 FAUDREE RD
Mailing Address - Street 2:TUSCANY APT F-301
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-8620
Mailing Address - Country:US
Mailing Address - Phone:347-987-0733
Mailing Address - Fax:
Practice Address - Street 1:302 SECOR ST
Practice Address - Street 2:GUPTA AND GUPTA PEDIATRICS MD PA
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6343
Practice Address - Country:US
Practice Address - Phone:432-685-5029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0468208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics