Provider Demographics
NPI:1891136784
Name:PATEL, MINAL
Entity type:Individual
Prefix:
First Name:MINAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14300 RONALD W REAGAN BLVD STE 405
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78641-6361
Mailing Address - Country:US
Mailing Address - Phone:512-931-1575
Mailing Address - Fax:
Practice Address - Street 1:14300 RONALD W REAGAN BLVD STE 405
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78641-6361
Practice Address - Country:US
Practice Address - Phone:512-931-1575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS244722080S0012X, 2080S0012X
TXT61452080S0012X, 2080S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00139522Medicaid
MS00139522Medicaid