Provider Demographics
NPI:1073044061
Name:PATEL, HANISH DILIPKUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:HANISH
Middle Name:DILIPKUMAR
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6403 LARKRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2705
Mailing Address - Country:US
Mailing Address - Phone:832-797-9091
Mailing Address - Fax:281-440-7895
Practice Address - Street 1:1906 BELLEVIEW AVE
Practice Address - Street 2:CARILION ROANOKE MEMORIAL HOSPITAL
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014
Practice Address - Country:US
Practice Address - Phone:540-981-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT7681207RP1001X
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program