Provider Demographics
NPI:1790012938
Name:PATEL, KETU (DC)
Entity type:Individual
Prefix:DR
First Name:KETU
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 HEATHERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-8900
Mailing Address - Country:US
Mailing Address - Phone:630-842-9224
Mailing Address - Fax:
Practice Address - Street 1:11500 N STEMMONS FWY
Practice Address - Street 2:SUITE 145
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-2184
Practice Address - Country:US
Practice Address - Phone:972-241-9977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11189111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor