Provider Demographics
NPI:1427354687
Name:PATEL, KUNAL KAUSHIK (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KUNAL
Middle Name:KAUSHIK
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 INDIANA BLVD
Mailing Address - Street 2:# 315
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226-1520
Mailing Address - Country:US
Mailing Address - Phone:512-992-6047
Mailing Address - Fax:
Practice Address - Street 1:2901 INDIANA BLVD
Practice Address - Street 2:# 315
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1520
Practice Address - Country:US
Practice Address - Phone:512-992-6047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX474911835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist