Provider Demographics
NPI:1821607466
Name:PATEL, VICKY MAHENDRA (DDS)
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:MAHENDRA
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5070 KLEIN ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-2532
Mailing Address - Country:US
Mailing Address - Phone:804-928-1700
Mailing Address - Fax:
Practice Address - Street 1:255 NORTHPOINT DR STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3269
Practice Address - Country:US
Practice Address - Phone:832-300-8040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice