Provider Demographics
NPI:1831176221
Name:PATEL, MANOJ K (MD)
Entity type:Individual
Prefix:
First Name:MANOJ
Middle Name:K
Last Name:PATEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2281 OLYMPIA DR
Mailing Address - Street 2:STE 100
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1857
Mailing Address - Country:US
Mailing Address - Phone:469-322-0089
Mailing Address - Fax:972-852-7963
Practice Address - Street 1:2281 OLYMPIA DR
Practice Address - Street 2:STE 100
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1857
Practice Address - Country:US
Practice Address - Phone:469-322-0089
Practice Address - Fax:972-852-7963
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2014-03-12
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Provider Licenses
StateLicense IDTaxonomies
TXK8411207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX039218501Medicaid
TX039218501Medicaid
TX8185J0Medicare ID - Type Unspecified