Provider Demographics
NPI:1518528850
Name:PATEL, KRISHNA DHARMENDRA (OD)
Entity type:Individual
Prefix:
First Name:KRISHNA
Middle Name:DHARMENDRA
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60160
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0160
Mailing Address - Country:US
Mailing Address - Phone:043-650-5557
Mailing Address - Fax:704-367-8120
Practice Address - Street 1:135 S SHARON AMITY RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3870
Practice Address - Country:US
Practice Address - Phone:704-365-0555
Practice Address - Fax:704-367-8120
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009008152W00000X
NC2794152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist