Provider Demographics
NPI:1588747729
Name:PATEL, JASMIN (LPT)
Entity type:Individual
Prefix:MS
First Name:JASMIN
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3533 TOWN CENTER BLVD SOUTH
Mailing Address - Street 2:# 400
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:281-313-4999
Mailing Address - Fax:281-313-4994
Practice Address - Street 1:3533 TOWN CENTER BLVD SOUTH
Practice Address - Street 2:# 400
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:281-313-4999
Practice Address - Fax:281-313-4994
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1050748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T4502OtherINDIV BCBS
TX0097MROtherGROUP BCBS
TX8T4502OtherINDIV BCBS
TX007922Medicare ID - Type UnspecifiedGROUP CMS