Provider Demographics
NPI:1831105790
Name:PATEL, RAJNIKANT R (MD)
Entity type:Individual
Prefix:DR
First Name:RAJNIKANT
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 WILLIAMS TRACE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4526
Mailing Address - Country:US
Mailing Address - Phone:281-747-7620
Mailing Address - Fax:281-747-7621
Practice Address - Street 1:2121 WILLIAMS TRACE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4526
Practice Address - Country:US
Practice Address - Phone:281-747-7620
Practice Address - Fax:281-747-7621
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9184207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134215603Medicaid
TXC20275Medicare UPIN
TX00QT89Medicare PIN