Provider Demographics
NPI:1952716318
Name:PATEL, HARSH B
Entity type:Individual
Prefix:
First Name:HARSH
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 W AVENUE A
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-4047
Mailing Address - Country:US
Mailing Address - Phone:254-778-6221
Mailing Address - Fax:254-742-0458
Practice Address - Street 1:1616 W AVENUE A
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-4047
Practice Address - Country:US
Practice Address - Phone:254-778-6221
Practice Address - Fax:254-742-0458
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX301601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice