Provider Demographics
NPI:1912033762
Name:YESROON PATEL MD PA
Entity Type:Organization
Organization Name:YESROON PATEL MD PA
Other - Org Name:BROWNSVILLE PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:YESROON
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-350-0010
Mailing Address - Street 1:5460 PAREDES LINE RD
Mailing Address - Street 2:206-328
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-9740
Mailing Address - Country:US
Mailing Address - Phone:956-350-0010
Mailing Address - Fax:956-350-0002
Practice Address - Street 1:100 E ALTON GLOOR BLVD
Practice Address - Street 2:SUITE # 120, VALLEY REGIONAL MED. PLAZA
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3328
Practice Address - Country:US
Practice Address - Phone:956-350-0010
Practice Address - Fax:956-350-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178566901Medicaid