Individual provider Active NPI

Sonam Kiritkumar Patel, O.D.

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1336577345
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8150-TG Issued in TX
Practice address
8917 Tehama Ridge Pkwy
Fort Worth, TX 76177-2005
Phone
(817) 879-7282
NPI assigned
Oct 30, 2013
Last updated
Oct 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2347 NC
Optometrist 152W00000X 8150-TG TX Primary

Addresses

Primary practice location

8917 Tehama Ridge Pkwy
Fort Worth, TX 76177-2005

Mailing address

8917 Tehama Ridge Pkwy
Fort Worth, TX 76177-2005
Phone (817) 879-7282

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2347NCMDMental Health Counselor
8150-TGTXMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1336577345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8917 TEHAMA RIDGE PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761772005",
            "telephone_number": "817-879-7282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8917 TEHAMA RIDGE PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761772005",
            "telephone_number": "817-879-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SONAM",
        "middle_name": "KIRITKUMAR",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2347",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8150-TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.