Basic Information
| Provider Information | |||||||||
| NPI: | 1407081920 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | KARISHMA | ||||||||
| MiddleName: | PRAVIN | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4310 MESA DR | ||||||||
| Address2: | |||||||||
| City: | DENTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762073460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9403875788 | ||||||||
| FaxNumber: | 9403816242 | ||||||||
| Practice Location | |||||||||
| Address1: | 4310 MESA DR | ||||||||
| Address2: | |||||||||
| City: | DENTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762073460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9403875788 | ||||||||
| FaxNumber: | 9403816242 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2009 | ||||||||
| LastUpdateDate: | 07/28/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA06160 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.