Provider Demographics
NPI:1104914407
Name:PATEL, MAYANK C (MD)
Entity type:Individual
Prefix:
First Name:MAYANK
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11920 ASTORIA BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6097
Mailing Address - Country:US
Mailing Address - Phone:281-484-9369
Mailing Address - Fax:281-484-1843
Practice Address - Street 1:11920 ASTORIA BLVD STE 320
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6097
Practice Address - Country:US
Practice Address - Phone:281-484-9369
Practice Address - Fax:281-484-1843
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL5087207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155323201Medicaid
TX8989B9Medicare PIN
TX155323201Medicaid