Provider Demographics
NPI:1609317262
Name:SOUTH DALLAS INFECTIOUS DISEASES PLLC
Entity type:Organization
Organization Name:SOUTH DALLAS INFECTIOUS DISEASES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONAK
Authorized Official - Middle Name:JASHVANTRAY
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-679-6722
Mailing Address - Street 1:13567 LEESON LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0806
Mailing Address - Country:US
Mailing Address - Phone:972-679-6722
Mailing Address - Fax:
Practice Address - Street 1:951 YORK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2052
Practice Address - Country:US
Practice Address - Phone:469-850-2697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3055207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty