Provider Demographics
NPI:1144558420
Name:PATEL, PRAKASH (PHARM D)
Entity type:Individual
Prefix:
First Name:PRAKASH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12300 JONES RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4802
Mailing Address - Country:US
Mailing Address - Phone:281-955-5619
Mailing Address - Fax:281-477-3214
Practice Address - Street 1:12300 JONES RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4802
Practice Address - Country:US
Practice Address - Phone:281-955-5619
Practice Address - Fax:281-477-3214
Is Sole Proprietor?:No
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39794183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist