Provider Demographics
NPI:1851607683
Name:PATEL, VIJAYBHAI B (DPT)
Entity Type:Individual
Prefix:
First Name:VIJAYBHAI
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 GREGORY AVE
Mailing Address - Street 2:APT#A9
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4858
Mailing Address - Country:US
Mailing Address - Phone:214-434-9418
Mailing Address - Fax:718-838-3665
Practice Address - Street 1:5881 VIRGINIA PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5402
Practice Address - Country:US
Practice Address - Phone:972-548-9993
Practice Address - Fax:972-548-8485
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2020-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1217543225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist