Provider Demographics
NPI:1194134247
Name:PATEL, PRIYA A (OD)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:A
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:333 E HIGHWAY 290 STE 419
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-5400
Mailing Address - Country:US
Mailing Address - Phone:512-375-4125
Mailing Address - Fax:
Practice Address - Street 1:333 E HIGHWAY 290 STE 419
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-5400
Practice Address - Country:US
Practice Address - Phone:512-375-4125
Practice Address - Fax:512-375-4184
Is Sole Proprietor?:No
Enumeration Date:2014-08-02
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00687500152W00000X
MDTA2439152W00000X
NYTUV008274152W00000X
TX10426T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist