Individual
SANTOSH CHANDRAKANT PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2625 BOLTON BOONE DR, DESOTO, TX 75115-2011
(972) 283-1516
(972) 283-1448
Mailing address
PO BOX 730990, DALLAS, TX 75373-0990
(972) 791-1224
(972) 692-7965
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M3352
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1877979 01
—
TX
01
—
8B7172
BCBS
TX
01
—
8BE521
BCBS
TX
Enumeration date
08/07/2006
Last updated
08/02/2010
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