Provider Demographics
NPI:1700806668
Name:PATEL, ANAND C (MD)
Entity type:Individual
Prefix:
First Name:ANAND
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 8TH AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2602
Mailing Address - Country:US
Mailing Address - Phone:682-224-3748
Mailing Address - Fax:
Practice Address - Street 1:3323 COLORADO BLVD STE 105
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6895
Practice Address - Country:US
Practice Address - Phone:682-224-3748
Practice Address - Fax:682-224-3748
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01060533A208600000X
HIMD-197232086S0102X
TXU9625208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000389850OtherBLUE CROSS
IN200523540Medicaid
IN677800NMedicare ID - Type Unspecified