Provider Demographics
NPI:1881782175
Name:PATEL, JAYENDRA K (MD)
Entity type:Individual
Prefix:DR
First Name:JAYENDRA
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4700 W SAM HOUSTON PKWY N STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-8224
Mailing Address - Country:US
Mailing Address - Phone:713-402-7824
Mailing Address - Fax:713-570-0196
Practice Address - Street 1:4700 W SAM HOUSTON PKWY N STE 220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-8224
Practice Address - Country:US
Practice Address - Phone:713-402-7824
Practice Address - Fax:713-570-0196
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5866207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161043802Medicaid
TX8197151OtherCIGNA
TXP3269429OtherUNITED HEALTHCARE
TX8K5589OtherBLUECROSS
TX7671195OtherAETNA
TX161043802Medicaid
TX10013964OtherAMERIGROUPSTAR
TX8K5589OtherBLUECROSS
TX10013964OtherAMERIGROUPSTAR
TXG68715Medicare UPIN