Provider Demographics
NPI:1578310199
Name:PATEL, DIPAKKUMAR C
Entity type:Individual
Prefix:
First Name:DIPAKKUMAR
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 NE 13TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-1038
Mailing Address - Country:US
Mailing Address - Phone:405-232-0404
Mailing Address - Fax:405-235-2129
Practice Address - Street 1:1117 NE 13TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-1038
Practice Address - Country:US
Practice Address - Phone:405-232-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging