Provider Demographics
NPI:1679584585
Name:PATEL, DEVANSHI G (MSPT)
Entity type:Individual
Prefix:
First Name:DEVANSHI
Middle Name:G
Last Name:PATEL
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11909 BRISTLEWOOD CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-2414
Mailing Address - Country:US
Mailing Address - Phone:832-326-1048
Mailing Address - Fax:
Practice Address - Street 1:11909 BRISTLEWOOD CV
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-2414
Practice Address - Country:US
Practice Address - Phone:832-326-1048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1127868225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G0712Medicare ID - Type Unspecified