Individual
STAVAN YOGENDRA PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP STE 410, SHREVEPORT, LA 71118-3157
(318) 212-5944
(318) 212-5949
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP STE 410, SHREVEPORT, LA 71118-3157
(318) 212-5944
(318) 212-5949
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
MD.302913
LA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
U0177
TX
Other
Enumeration date
05/03/2010
Last updated
11/21/2024
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