Provider Demographics
NPI:1396461059
Name:PRIYA PATEL OD PLLC
Entity type:Organization
Organization Name:PRIYA PATEL OD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OD/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:304-266-9453
Mailing Address - Street 1:333 E HIGHWAY 290 STE 419
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-5400
Mailing Address - Country:US
Mailing Address - Phone:123-754-1255
Mailing Address - Fax:512-375-4184
Practice Address - Street 1:333 E HIGHWAY 290 STE 419
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-5400
Practice Address - Country:US
Practice Address - Phone:512-375-4125
Practice Address - Fax:512-375-4184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty