Provider Demographics
NPI:1538707708
Name:PATEL, JEFFREY Q (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:Q
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 1:662 BONHAM ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-4118
Mailing Address - Country:US
Mailing Address - Phone:903-784-2536
Mailing Address - Fax:903-784-1063
Practice Address - Street 1:662 BONHAM ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-4118
Practice Address - Country:US
Practice Address - Phone:903-784-2536
Practice Address - Fax:903-784-1063
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist