Provider Demographics
NPI:1306165014
Name:PATEL, DERINBHAI J (MD)
Entity type:Individual
Prefix:
First Name:DERINBHAI
Middle Name:J
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DERIN
Other - Middle Name:J
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:12881 N IH 35
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-2966
Mailing Address - Country:US
Mailing Address - Phone:210-742-6555
Mailing Address - Fax:224-623-0079
Practice Address - Street 1:12881 N IH 35
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-2966
Practice Address - Country:US
Practice Address - Phone:210-742-6555
Practice Address - Fax:224-623-0079
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3416207R00000X
KY45793207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP01213112OtherRAILROAD MEDICARE
KYK094660Medicare PIN