Provider Demographics
NPI:1952535627
Name:PATEL, SHALIZEH AZIZI (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHALIZEH
Middle Name:AZIZI
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2218 NAOMI ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3824
Mailing Address - Country:US
Mailing Address - Phone:214-288-7919
Mailing Address - Fax:713-500-4108
Practice Address - Street 1:6516 M D ANDERSON BLVD
Practice Address - Street 2:SUITE 493
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3402
Practice Address - Country:US
Practice Address - Phone:214-288-7919
Practice Address - Fax:713-500-4108
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20498122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX-20498OtherNO INSURANCE TAKEN