Active NPI
Varun Patel
- Military Health Care Provider
- Jbsa Ft Sam Houston, TX
National Provider Identifier
1063110351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- Practice address
- 3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504 - Phone
- (630) 506-1324
- NPI assigned
- Feb 16, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Military Health Care Provider | 171000000X | Primary |
Addresses
Primary practice location
3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Mailing address
4819 68TH Street Cir E
Bradenton, FL 34203-4655
Phone (630) 506-1324
Other practice location 1
1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 671-1110
Other practice location 2
5000 Lakewood Ranch Blvd
Bradenton, FL 34211-4909
Phone (941) 756-0690
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691625600000",
"number": "1063110351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4819 68TH STREET CIR E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342034655",
"telephone_number": "630-506-1324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "JBSA FT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "630-506-1324"
}
],
"practiceLocations": [
{
"address_1": "1100 Wilford Hall Loop Bldg 4554",
"address_purpose": "LOCATION",
"city": "Jbsa Lackland",
"state": "TX",
"postal_code": "782365638",
"country_code": "US",
"telephone_number": "210-671-1110",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5000 Lakewood Ranch Blvd",
"address_purpose": "LOCATION",
"city": "Bradenton",
"state": "FL",
"postal_code": "342114909",
"country_code": "US",
"telephone_number": "941-756-0690",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATEL",
"first_name": "VARUN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-16",
"last_updated": "2023-08-10",
"certification_date": "2023-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jbsa Ft Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.