Basic Information
| Provider Information | |||||||||
| NPI: | 1447742606 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | ANKUR | ||||||||
| MiddleName: | MAHENDRA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 MARKET POINT DR APT 7206 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296077900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8032925666 | ||||||||
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| Practice Location | |||||||||
| Address1: | 104 STATION DR | ||||||||
| Address2: | |||||||||
| City: | ANDERSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296211173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8643324640 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2018 | ||||||||
| LastUpdateDate: | 06/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2062 | SC | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.