Provider Demographics
NPI:1124514393
Name:PATAGARLA, ALEKHYA (DDS)
Entity type:Individual
Prefix:
First Name:ALEKHYA
Middle Name:
Last Name:PATAGARLA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 N HIGHWAY 78 STE 150
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-6091
Mailing Address - Country:US
Mailing Address - Phone:972-961-1744
Mailing Address - Fax:972-961-1745
Practice Address - Street 1:2014 N HIGHWAY 78 STE 150
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-6091
Practice Address - Country:US
Practice Address - Phone:972-961-1744
Practice Address - Fax:972-961-1745
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343881223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice