Basic Information
Provider Information
NPI: 1013234996
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: BHAVIK
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6161 S YALE AVE
Address2:  
City: TULSA
State: OK
PostalCode: 741361902
CountryCode: US
TelephoneNumber: 9185021900
FaxNumber: 9184946303
Practice Location
Address1: 1500 S MAIN ST
Address2:  
City: FORT WORTH
State: TX
PostalCode: 761044917
CountryCode: US
TelephoneNumber: 8177023431
FaxNumber: 8179273603
Other Information
ProviderEnumerationDate: 04/30/2010
LastUpdateDate: 03/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XQ1879TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X30087OKY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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