Provider Demographics
NPI:1225870868
Name:PATIDAR, UMA KANTI (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:UMA
Middle Name:KANTI
Last Name:PATIDAR
Suffix:
Gender:
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2113 ENCHANTED ROCK WAY
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-3040
Mailing Address - Country:US
Mailing Address - Phone:413-475-0642
Mailing Address - Fax:
Practice Address - Street 1:6300 W PARKER RD STE 224
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8102
Practice Address - Country:US
Practice Address - Phone:469-574-0464
Practice Address - Fax:469-574-0471
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1171169363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty