Provider Demographics
NPI:1902836166
Name:OPHTHALMOLOGY SPECIALISTS OF TEXAS, PLLC
Entity Type:Organization
Organization Name:OPHTHALMOLOGY SPECIALISTS OF TEXAS, PLLC
Other - Org Name:OPHTHALMOLOGY SPECIALISTS OF TEXAS P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:325-690-4429
Mailing Address - Street 1:5441 HEALTH CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-1224
Mailing Address - Country:US
Mailing Address - Phone:325-690-4429
Mailing Address - Fax:325-690-4438
Practice Address - Street 1:5441 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-1224
Practice Address - Country:US
Practice Address - Phone:325-673-9806
Practice Address - Fax:325-673-9809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4185207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149926102Medicaid
TX00178TMedicare ID - Type Unspecified