Individual
SAMIR PRAVINCHANDRA PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3903 WISEMAN BLVD, STE 311, SAN ANTONIO, TX 78251-4422
(210) 615-1901
(210) 615-1905
Mailing address
P.O. BOX 117614, CARROLLTON, TX 75011-7614
(210) 615-1901
(210) 615-1905
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2013-01741
NC
207L00000X
Anesthesiology Physician
P3056
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
P3056
TX
208VP0000X
Pain Medicine Physician
2013-01741
NC
208VP0000X
Pain Medicine Physician
Primary
P3056
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
296904001
—
TX
01
—
296904002
CSHCN
TX
Enumeration date
06/12/2008
Last updated
07/08/2021
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