Provider Demographics
NPI:1265403059
Name:PATEL, ASHOK G (MD)
Entity type:Individual
Prefix:
First Name:ASHOK
Middle Name:G
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2137
Mailing Address - Country:US
Mailing Address - Phone:972-291-4289
Mailing Address - Fax:972-291-5429
Practice Address - Street 1:500 N HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2137
Practice Address - Country:US
Practice Address - Phone:972-291-4289
Practice Address - Fax:972-291-5429
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF-7367207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000CQ110Medicaid
TX00CQ11Medicare PIN
TXC20278Medicare UPIN