Provider Demographics
NPI:1245548270
Name:PATEL, RENA ISHVARLAL (OD)
Entity type:Individual
Prefix:DR
First Name:RENA
Middle Name:ISHVARLAL
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 POLO DOWNS
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-7600
Mailing Address - Country:US
Mailing Address - Phone:205-482-1337
Mailing Address - Fax:
Practice Address - Street 1:300 EAST ST N
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-2085
Practice Address - Country:US
Practice Address - Phone:256-362-5800
Practice Address - Fax:256-362-3062
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-C35-TA-872152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist