Individual
TARAK J PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4114 POND HILL ROAD, SUITE 101, SAN ANTONIO, TX 78231
(210) 249-5020
(210) 494-2209
Mailing address
4114 POND HILL RD STE 101, SAN ANTONIO, TX 78231-1273
(210) 249-5020
(210) 572-1540
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
K5652
TX
2080P0214X
Pediatric Pulmonology Physician
Primary
K5652
TX
2080S0012X
Pediatric Sleep Medicine Physician
K5652
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047712706
MEDICAID - SAN ANTONIO
TX
01
—
047712707
MEDICAID - HOUSTON
TX
01
—
8F21480
MEDICARE- SAN ANTONIO
TX
01
—
8F22537
MEDICARE- HOUSTON
TX
Enumeration date
05/31/2006
Last updated
12/22/2023
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