Provider Demographics
NPI:1134562598
Name:PATEL, MITESH MAHESH (DO)
Entity type:Individual
Prefix:DR
First Name:MITESH
Middle Name:MAHESH
Last Name:PATEL
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Gender:M
Credentials:DO
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Mailing Address - Street 1:208 OAK DR S
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5790
Mailing Address - Country:US
Mailing Address - Phone:979-285-3633
Mailing Address - Fax:979-285-3626
Practice Address - Street 1:208 OAK DR S
Practice Address - Street 2:SUITE 200
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5790
Practice Address - Country:US
Practice Address - Phone:979-285-3633
Practice Address - Fax:979-285-3626
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2016-08-16
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Provider Licenses
StateLicense IDTaxonomies
TXQ5896207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine