Provider Demographics
NPI:1073810990
Name:PATEL, ATISH D
Entity type:Individual
Prefix:DR
First Name:ATISH
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ATISH
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:12221 MERIT DR.
Mailing Address - Street 2:STE. 1500
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251
Mailing Address - Country:US
Mailing Address - Phone:214-217-1900
Mailing Address - Fax:214-217-1912
Practice Address - Street 1:12221 MERIT DR.
Practice Address - Street 2:STE. 1500
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251
Practice Address - Country:US
Practice Address - Phone:214-217-1900
Practice Address - Fax:214-217-1912
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7255207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine