Provider Demographics
NPI:1811088800
Name:PATEL, VIREN B (DO)
Entity type:Individual
Prefix:DR
First Name:VIREN
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 COAST LINE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-3522
Mailing Address - Country:US
Mailing Address - Phone:702-809-4140
Mailing Address - Fax:702-259-4843
Practice Address - Street 1:7010 SMOKE RANCH RD
Practice Address - Street 2:STE120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-3123
Practice Address - Country:US
Practice Address - Phone:702-477-7044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV883207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018623Medicaid
NVH24705Medicare UPIN
NVV34028Medicare PIN