Provider Demographics
NPI:1932333259
Name:PATEL, SHOBHNA (OTR)
Entity Type:Individual
Prefix:
First Name:SHOBHNA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 LAVACA DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-3556
Mailing Address - Country:US
Mailing Address - Phone:972-509-2159
Mailing Address - Fax:866-323-1955
Practice Address - Street 1:4325 LAVACA DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-3556
Practice Address - Country:US
Practice Address - Phone:972-509-2159
Practice Address - Fax:866-323-1955
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107426225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist