Provider Demographics
NPI:1306952627
Name:PATEL, DEVANG (MD)
Entity type:Individual
Prefix:
First Name:DEVANG
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4411 MEDICAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3824
Mailing Address - Country:US
Mailing Address - Phone:210-614-5400
Mailing Address - Fax:210-614-2413
Practice Address - Street 1:1139 E SONTERRA BLVD STE 520
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4347
Practice Address - Country:US
Practice Address - Phone:210-490-6000
Practice Address - Fax:210-490-4658
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4629207RI0011X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CM513OtherBCBS
TXTXB112501OtherMEDICARE
TXP00898262OtherRAILROAD MEDICARE
TX154601204Medicaid
TX154601204Medicaid
TX8CM513OtherBCBS
TXP00898262OtherRAILROAD MEDICARE
TX060069908Medicare PIN
TX8CM513OtherBCBS
TX060069908Medicare PIN