Provider Demographics
NPI:1285920025
Name:PATEL, PRIYANKA P (OD)
Entity type:Individual
Prefix:DR
First Name:PRIYANKA
Middle Name:P
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 W LEE HWY
Mailing Address - Street 2:SUITE 632
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2093
Mailing Address - Country:US
Mailing Address - Phone:540-428-3937
Mailing Address - Fax:
Practice Address - Street 1:251 W LEE HWY
Practice Address - Street 2:SUITE 632
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2093
Practice Address - Country:US
Practice Address - Phone:540-428-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002050152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist