Provider Demographics
NPI:1851629273
Name:PATEL, MALA R (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MALA
Middle Name:R
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12025 HUFFMEISTER RD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3244
Mailing Address - Country:US
Mailing Address - Phone:281-955-8344
Mailing Address - Fax:281-955-8468
Practice Address - Street 1:12025 HUFFMEISTER RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3244
Practice Address - Country:US
Practice Address - Phone:281-955-8344
Practice Address - Fax:281-955-8468
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47014183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist