Provider Demographics
NPI:1336552967
Name:PATIL, JYOTIBEN (RN, BSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:JYOTIBEN
Middle Name:
Last Name:PATIL
Suffix:
Gender:F
Credentials:RN, BSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17320 RED OAK DR
Mailing Address - Street 2:STE 260
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2643
Mailing Address - Country:US
Mailing Address - Phone:646-639-4696
Mailing Address - Fax:
Practice Address - Street 1:17320 RED OAK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2633
Practice Address - Country:US
Practice Address - Phone:832-295-9829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2017-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX848048363LF0000X
NYF338006363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily