Provider Demographics
NPI:1639905326
Name:PATEL, SALONI DHRUV
Entity type:Individual
Prefix:
First Name:SALONI
Middle Name:DHRUV
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 1:301 E STATE HIGHWAY 243 STE 121
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:TX
Mailing Address - Zip Code:75103-2418
Mailing Address - Country:US
Mailing Address - Phone:903-567-4692
Mailing Address - Fax:
Practice Address - Street 1:301 E STATE HIGHWAY 243 STE 121
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:TX
Practice Address - Zip Code:75103-2418
Practice Address - Country:US
Practice Address - Phone:903-567-4692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant