Provider Demographics
NPI:1033732649
Name:PATEL, PRITAL MEHTA (OD)
Entity type:Individual
Prefix:DR
First Name:PRITAL
Middle Name:MEHTA
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:15933 CLAYTON RD STE 210
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2172
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:1575 NC HIGHWAY 66 S
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3516
Practice Address - Country:US
Practice Address - Phone:336-993-8514
Practice Address - Fax:336-993-6950
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2732152W00000X
OHOPT.006879152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist