Provider Demographics
NPI:1780347476
Name:PATEL, BHAVINKUMAR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BHAVINKUMAR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 CANYON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3293
Mailing Address - Country:US
Mailing Address - Phone:254-774-1600
Mailing Address - Fax:254-774-1610
Practice Address - Street 1:937 CANYON CREEK DR
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3293
Practice Address - Country:US
Practice Address - Phone:254-774-1600
Practice Address - Fax:254-774-1610
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist