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Individual

DR. SHIVAM PATEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
11831 CULEBRA RD STE 101, SAN ANTONIO, TX 78253-4578
(210) 625-5353
Mailing address
11831 CULEBRA RD STE 101, SAN ANTONIO, TX 78253-4578
(210) 625-5353

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
40315
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0011976
OH
Enumeration date
02/23/2022
Last updated
06/17/2024
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