Provider Demographics
NPI:1982916169
Name:PATEL, KRISHAN (DDS)
Entity Type:Individual
Prefix:
First Name:KRISHAN
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 PARKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-4263
Mailing Address - Country:US
Mailing Address - Phone:512-339-7848
Mailing Address - Fax:512-339-7862
Practice Address - Street 1:11100 PARKFIELD DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-4263
Practice Address - Country:US
Practice Address - Phone:512-339-7848
Practice Address - Fax:512-339-7862
Is Sole Proprietor?:No
Enumeration Date:2010-07-05
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26237122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist