Provider Demographics
NPI:1730241563
Name:PATEL, AMAR SUHAS (MD)
Entity type:Individual
Prefix:
First Name:AMAR
Middle Name:SUHAS
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 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:2727 W HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1669
Practice Address - Country:US
Practice Address - Phone:713-442-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN03522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX307296902Medicaid
TX307296903Medicaid
TXTXB157664Medicare PIN
TXTXB157666Medicare PIN
FLAE556XMedicare PIN
FLAE566YMedicare PIN
GA848621867AMedicaid
FLAE556UMedicare PIN
FLP00441216Medicare PIN
FLAE556OMedicare PIN
FLAE556MMedicare PIN
FLAE556ZMedicare PIN
FLAE556TMedicare PIN
FLAE556NMedicare PIN
FL2784343-00Medicaid
FLAE556SMedicare PIN
FL78328OtherBCBS