Provider Demographics
NPI:1134606916
Name:PATEL, ROSHANI (OD)
Entity type:Individual
Prefix:
First Name:ROSHANI
Middle Name:
Last Name:PATEL
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 SUNSET LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-3793
Mailing Address - Country:US
Mailing Address - Phone:919-303-4445
Mailing Address - Fax:919-303-4447
Practice Address - Street 1:5225 SUNSET LAKE RD
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-3793
Practice Address - Country:US
Practice Address - Phone:919-303-4445
Practice Address - Fax:919-303-4447
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003115152W00000X
NC2705152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist