Provider Demographics
NPI:1154520351
Name:PATEL, SNEHA (PAC)
Entity type:Individual
Prefix:
First Name:SNEHA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N PEARL ST
Mailing Address - Street 2:SUITE N510
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-2824
Mailing Address - Country:US
Mailing Address - Phone:214-580-7277
Mailing Address - Fax:214-580-7283
Practice Address - Street 1:700 N PEARL ST
Practice Address - Street 2:SUITE N208
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-2824
Practice Address - Country:US
Practice Address - Phone:214-999-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03100207Q00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03100OtherMEDICAL LICENSE- PAC