Provider Demographics
NPI:1588916514
Name:PATEL, MONABEN I (FNP)
Entity type:Individual
Prefix:
First Name:MONABEN
Middle Name:I
Last Name:PATEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 HOSPITAL PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-5934
Mailing Address - Country:US
Mailing Address - Phone:817-684-3500
Mailing Address - Fax:817-684-3510
Practice Address - Street 1:1615 HOSPITAL PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-5934
Practice Address - Country:US
Practice Address - Phone:817-684-3500
Practice Address - Fax:817-684-3510
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX334991YL7AOtherMEDICARE - OTHER COUNTY
TXP01430886OtherRAILROAD MEDICARE
TX334991YNGSMedicare PIN