Provider Demographics
NPI:1992797302
Name:PATEL, VINAYCHANDRA MAGANBHAI (MD)
Entity type:Individual
Prefix:DR
First Name:VINAYCHANDRA
Middle Name:MAGANBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:VINAY
Other - Middle Name:M
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1700 CURIE DR
Mailing Address - Street 2:SUITE 5000
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2905
Mailing Address - Country:US
Mailing Address - Phone:915-545-1252
Mailing Address - Fax:915-545-1278
Practice Address - Street 1:1700 CURIE DR
Practice Address - Street 2:SUITE 5000
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2905
Practice Address - Country:US
Practice Address - Phone:915-545-1252
Practice Address - Fax:915-545-1278
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8081174400000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103153601Medicaid
TX839654OtherBLUE CROSS AND BLUE SHIELD OF TEXAS
TXF67373Medicare UPIN
TX839654OtherBLUE CROSS AND BLUE SHIELD OF TEXAS