Provider Demographics
NPI:1306936018
Name:PATEL, ASHVIN (MD)
Entity type:Individual
Prefix:
First Name:ASHVIN
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 S ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1728
Mailing Address - Country:US
Mailing Address - Phone:361-852-6996
Mailing Address - Fax:361-852-4727
Practice Address - Street 1:3435 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1751
Practice Address - Country:US
Practice Address - Phone:361-852-6996
Practice Address - Fax:361-852-4727
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9258208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG08133OtherUPIN
TX120562705Medicaid
TX120562706Medicaid
TX0095GXOtherBLUE CROSS BLUE SHIELD