Provider Demographics
NPI:1336800531
Name:PATEL, SHWETA
Entity Type:Individual
Prefix:
First Name:SHWETA
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 1:318 CYPRESS WALK WAY
Mailing Address - Street 2:
Mailing Address - City:WANDO
Mailing Address - State:SC
Mailing Address - Zip Code:29492-7986
Mailing Address - Country:US
Mailing Address - Phone:713-835-8192
Mailing Address - Fax:
Practice Address - Street 1:318 CYPRESS WALK WAY
Practice Address - Street 2:
Practice Address - City:WANDO
Practice Address - State:SC
Practice Address - Zip Code:29492-7986
Practice Address - Country:US
Practice Address - Phone:713-835-8192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC246260163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse