Provider Demographics
NPI:1215349121
Name:PATEL, KALPESH L (LAC)
Entity type:Individual
Prefix:MR
First Name:KALPESH
Middle Name:L
Last Name:PATEL
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 E SOUTHLAKE BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-7068
Mailing Address - Country:US
Mailing Address - Phone:972-863-2895
Mailing Address - Fax:972-692-7404
Practice Address - Street 1:1835 E SOUTHLAKE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7068
Practice Address - Country:US
Practice Address - Phone:972-863-2895
Practice Address - Fax:972-692-7404
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01462171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist