Provider Demographics
NPI:1104111764
Name:PATEL, SIMINI (RPH)
Entity type:Individual
Prefix:MRS
First Name:SIMINI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 S MOPAC
Mailing Address - Street 2:T-1061
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-1112
Mailing Address - Country:US
Mailing Address - Phone:512-892-3753
Mailing Address - Fax:512-892-3753
Practice Address - Street 1:5300 S MOPAC
Practice Address - Street 2:T-1061
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1112
Practice Address - Country:US
Practice Address - Phone:512-892-3753
Practice Address - Fax:512-892-3753
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-12
Last Update Date:2011-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36126183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist