Provider Demographics
NPI:1013170950
Name:RAJASHRI PATIL MD PA
Entity type:Organization
Organization Name:RAJASHRI PATIL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJASHRI
Authorized Official - Middle Name:I
Authorized Official - Last Name:PATIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-306-4030
Mailing Address - Street 1:8210 WALNUT HILL LN
Mailing Address - Street 2:BLDG 1 ,STE 306
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4405
Mailing Address - Country:US
Mailing Address - Phone:214-306-4030
Mailing Address - Fax:214-242-6758
Practice Address - Street 1:8210 WALNUT HILL LN
Practice Address - Street 2:BLDG 1 ,STE 306
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4405
Practice Address - Country:US
Practice Address - Phone:214-306-4030
Practice Address - Fax:214-242-6758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2746207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty