Basic Information
| Provider Information | |||||||||
| NPI: | 1700176369 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | UMANG | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 911230 | ||||||||
| Address2: | DALLAS | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753911230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729978000 | ||||||||
| FaxNumber: | 9722342987 | ||||||||
| Practice Location | |||||||||
| Address1: | 9323 PINECROFT DR | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | THE WOODLANDS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773803749 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2819432440 | ||||||||
| FaxNumber: | 2819432404 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2011 | ||||||||
| LastUpdateDate: | 07/27/2017 | ||||||||
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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 | 2085R0001X | Q6259 | TX | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 111815002 | 01 | TX | GROUP MEDICAID | OTHER | 365668801 | 05 | TX | MEDICAID | 0019BY | 01 | TX | GROUP MEDICARE | OTHER | 365668802 | 05 | TX | MEDICAID | 365668803 | 05 | TX | MEDICAID |