Provider Demographics
NPI:1972516516
Name:PANKAJ V. PATEL, M.D.,P.A.
Entity type:Organization
Organization Name:PANKAJ V. PATEL, M.D.,P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PANKAJ
Authorized Official - Middle Name:V
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACC
Authorized Official - Phone:432-580-3775
Mailing Address - Street 1:PO BOX 8729
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79708-8729
Mailing Address - Country:US
Mailing Address - Phone:432-580-3775
Mailing Address - Fax:432-580-8310
Practice Address - Street 1:540 W 5TH ST STE 310
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-5062
Practice Address - Country:US
Practice Address - Phone:432-580-3775
Practice Address - Fax:432-580-8310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00303VMedicare ID - Type Unspecified