Provider Demographics
NPI:1558895771
Name:PATEL, JIGAR (MD)
Entity type:Individual
Prefix:
First Name:JIGAR
Middle Name:
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 1:1450 W LONG LAKE RD STE 340
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-6330
Mailing Address - Country:US
Mailing Address - Phone:248-905-5091
Mailing Address - Fax:248-905-5096
Practice Address - Street 1:3101 S AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626
Practice Address - Country:US
Practice Address - Phone:248-905-5091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1559042084P0800X
TXS82302084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry