Provider Demographics
NPI:1659303824
Name:PATEL, SATISKUMAR P (MD MBCHB)
Entity type:Individual
Prefix:DR
First Name:SATISKUMAR
Middle Name:P
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD MBCHB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TX
Mailing Address - Zip Code:77535-2642
Mailing Address - Country:US
Mailing Address - Phone:936-258-4920
Mailing Address - Fax:936-258-4927
Practice Address - Street 1:108 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TX
Practice Address - Zip Code:77535-2642
Practice Address - Country:US
Practice Address - Phone:936-258-4920
Practice Address - Fax:936-258-4927
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3353207Q00000X
MS18597207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSI22219Medicare UPIN