Provider Demographics
NPI:1962410100
Name:PATEL, KARTIK NARENDRA (DO)
Entity type:Individual
Prefix:DR
First Name:KARTIK
Middle Name:NARENDRA
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:254-724-8800
Mailing Address - Fax:
Practice Address - Street 1:2401 S 31ST ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508-0001
Practice Address - Country:US
Practice Address - Phone:254-724-0454
Practice Address - Fax:254-724-0454
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3056207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1840183-04Medicaid
TX184018301Medicaid
TX184018303Medicaid
TX8X2740OtherBCBS
TX184018303Medicaid
TX8F8899Medicare PIN
TX184018301Medicaid
TX8J2719Medicare PIN
TXI70068Medicare UPIN
TXTXB118678Medicare PIN