Provider Demographics
NPI:1669728028
Name:PATEL, RIDDHIBEN S (MD)
Entity type:Individual
Prefix:
First Name:RIDDHIBEN
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7940 SHOAL CREEK BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-7589
Mailing Address - Country:US
Mailing Address - Phone:512-494-4000
Mailing Address - Fax:
Practice Address - Street 1:1301 MEDICAL PKWY STE 300
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2529
Practice Address - Country:US
Practice Address - Phone:512-494-4000
Practice Address - Fax:512-494-4045
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301100123208000000X
MS237292084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL196655Medicaid
MS06337068Medicaid
MS426392YJ5DMedicare PIN