Provider Demographics
NPI:1053783902
Name:BIMAL PATEL LLC
Entity type:Organization
Organization Name:BIMAL PATEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BIMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:832-715-0974
Mailing Address - Street 1:1403 ELGIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-2832
Mailing Address - Country:US
Mailing Address - Phone:832-715-0974
Mailing Address - Fax:
Practice Address - Street 1:515 WESTHEIMER RD
Practice Address - Street 2:STE A-2
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-2931
Practice Address - Country:US
Practice Address - Phone:832-715-0974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty