Provider Demographics
NPI:1831101336
Name:PATEL, NIRAJ C (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRAJ
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 TOWN CENTER BLVD S
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-1285
Mailing Address - Country:US
Mailing Address - Phone:281-499-4999
Mailing Address - Fax:281-657-6711
Practice Address - Street 1:3525 TOWN CENTER BLVD S
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1285
Practice Address - Country:US
Practice Address - Phone:281-499-4999
Practice Address - Fax:281-657-6711
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5373174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101810302Medicaid
TXH00600Medicare UPIN
TX101810302Medicaid