Provider Demographics
NPI:1801011846
Name:NARESH PATEL, MD PA
Entity type:Organization
Organization Name:NARESH PATEL, MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NARESH
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-877-8885
Mailing Address - Street 1:800 8TH AVE
Mailing Address - Street 2:SUITE 632
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2601
Mailing Address - Country:US
Mailing Address - Phone:817-877-8885
Mailing Address - Fax:817-877-3004
Practice Address - Street 1:800 8TH AVE
Practice Address - Street 2:SUITE 632
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2601
Practice Address - Country:US
Practice Address - Phone:817-877-8885
Practice Address - Fax:817-877-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0065EKOtherBLUE CROSS BLUE SHIELD
TX131137506Medicaid
TX131137506Medicaid
TX00276LMedicare PIN