Provider Demographics
NPI:1255117321
Name:PATEL, HIMANSHU
Entity type:Individual
Prefix:
First Name:HIMANSHU
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 EVANS OAK LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-7705
Mailing Address - Country:US
Mailing Address - Phone:973-752-8357
Mailing Address - Fax:210-568-4806
Practice Address - Street 1:322 EVANS OAK LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-7705
Practice Address - Country:US
Practice Address - Phone:973-752-8357
Practice Address - Fax:210-568-4806
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53997183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist