Provider Demographics
NPI:1992977284
Name:RAJESH J PATEL, M.D., P.A.
Entity type:Organization
Organization Name:RAJESH J PATEL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, RAJESH J PATEL,M.D., PA.
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-580-8000
Mailing Address - Street 1:PO BOX 3942
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79760-3942
Mailing Address - Country:US
Mailing Address - Phone:432-580-8000
Mailing Address - Fax:
Practice Address - Street 1:601 GOLDER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4412
Practice Address - Country:US
Practice Address - Phone:432-580-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9782207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136462206Medicaid
TX00Z568Medicare PIN