Provider Demographics
NPI:1700804580
Name:PATOLIA, DOLAR S (MD)
Entity Type:Individual
Prefix:DR
First Name:DOLAR
Middle Name:S
Last Name:PATOLIA
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 1:7400 FANNIN ST
Mailing Address - Street 2:STE 755
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1920
Mailing Address - Country:US
Mailing Address - Phone:713-658-0358
Mailing Address - Fax:713-658-9414
Practice Address - Street 1:7400 FANNIN ST
Practice Address - Street 2:STE 755
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1920
Practice Address - Country:US
Practice Address - Phone:713-658-0358
Practice Address - Fax:713-658-9414
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8414207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030306701Medicaid
TX00074QMedicare ID - Type Unspecified
TX030306701Medicaid