Provider Demographics
NPI:1245520139
Name:PATEL, RACHNA
Entity type:Individual
Prefix:
First Name:RACHNA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S MAIN ST # 723
Mailing Address - Street 2:
Mailing Address - City:RHOME
Mailing Address - State:TX
Mailing Address - Zip Code:76078-4489
Mailing Address - Country:US
Mailing Address - Phone:973-978-9247
Mailing Address - Fax:
Practice Address - Street 1:500 S MAIN ST # 723
Practice Address - Street 2:
Practice Address - City:RHOME
Practice Address - State:TX
Practice Address - Zip Code:76078-4489
Practice Address - Country:US
Practice Address - Phone:973-978-9247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12062207P00000X, 208D00000X
CA20A12063208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine