Amit M Patel, PHARMD

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Dulce, NM

NPI 1679163893 · NPPES record last updated Jan 21, 2021

Key facts

NPI
1679163893
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
65504 (TX)
Practice address
500 Mundo Rd
Dulce, NM 87528
Phone
(575) 759-3291
NPI assigned
Jan 21, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
65504TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Dulce Health Center Current
since Jan 24, 2021
Accepting new patients
Jicarilla IHS Pharmacy Current
since Mar 5, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 65504 TX Yes

Addresses

Primary practice location

500 Mundo Rd
Dulce, NM 87528

Mailing address

1910 Wyster Dr
Garland, TX 75040-4587
Phone (214) 208-6218

Other identifiers

IdentifierTypeStateIssuer
18347904OtherTXDRIVER LICENSE

Other providers in Dulce, NM

All providers in Dulce, NM · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New Mexico

Sources for this page

Verify at the official NPI Registry.