Provider Demographics
NPI:1700455904
Name:PAT MED PA
Entity type:Organization
Organization Name:PAT MED PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATANKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-296-8549
Mailing Address - Street 1:5315 PRIAMUS DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1857
Mailing Address - Country:US
Mailing Address - Phone:954-296-8549
Mailing Address - Fax:
Practice Address - Street 1:5315 PRIAMUS DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-1857
Practice Address - Country:US
Practice Address - Phone:954-296-8549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty