Organization
PREVENTIVE MEDICINE INSTITUTE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAYA R PATEL M.D (MEDICAL DIRECTOR)
(281) 277-9898
Entity
Organization
Contact information
Practice address
16651 SOUTHWEST FWY, SUITE 300, SUGAR LAND, TX 77479-2345
(281) 277-9898
Mailing address
16651 SOUTHWEST FWY STE 300, SUGAR LAND, TX 77479-2348
(281) 277-9898
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
K7197
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021EP
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/27/2007
Last updated
07/07/2014
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