Provider Demographics
NPI:1851656318
Name:PATEL, NILESH (DPM)
Entity Type:Individual
Prefix:DR
First Name:NILESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 ESPERANZA XING
Mailing Address - Street 2:APT #6330
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-3769
Mailing Address - Country:US
Mailing Address - Phone:503-991-1819
Mailing Address - Fax:
Practice Address - Street 1:9012 RESEARCH BLVD
Practice Address - Street 2:SUITE C13
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-7093
Practice Address - Country:US
Practice Address - Phone:503-991-1819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2171213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery