Provider Demographics
NPI:1013236637
Name:PATEL, RUPAL M (DPT)
Entity Type:Individual
Prefix:
First Name:RUPAL
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 E 6TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-3374
Mailing Address - Country:US
Mailing Address - Phone:512-297-2860
Mailing Address - Fax:512-870-9471
Practice Address - Street 1:2124 E 6TH ST
Practice Address - Street 2:UNIT 106
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-3494
Practice Address - Country:US
Practice Address - Phone:512-965-7080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1176760225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist