Provider Demographics
NPI:1730492497
Name:PATEL PSYCHIATRY CONSULTANT
Entity type:Organization
Organization Name:PATEL PSYCHIATRY CONSULTANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIVYANSU
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-302-1954
Mailing Address - Street 1:3724 JEFFERSON ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6225
Mailing Address - Country:US
Mailing Address - Phone:512-302-1954
Mailing Address - Fax:512-302-1829
Practice Address - Street 1:3724 JEFFERSON ST
Practice Address - Street 2:SUITE 207
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6225
Practice Address - Country:US
Practice Address - Phone:512-302-1954
Practice Address - Fax:512-302-1829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)