Modern Gynecology, PLLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

M3682 Issued in TX

Legal business name

MODERN GYNECOLOGY, PLLC

Practice address

3822 Bowser Ave.
Dallas, TX 75219-4301

Phone

(214) 604-5440

NPI assigned

Aug 30, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Amit Indravadan Patel, M.D.NPI 1336131812

Title

Manager/ President

Phone

(214) 604-5440

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amit Indravadan Patel, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Plano, TX
  • NPI 1336131812
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346284800000",
    "number": "1982953469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3822 BOWSER AVE.",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194301",
            "telephone_number": "214-604-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3822 BOWSER AVE.",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194301",
            "telephone_number": "214-604-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN GYNECOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-30",
        "last_updated": "2012-08-30",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AMIT",
        "authorized_official_middle_name": "INDRAVADAN",
        "authorized_official_title_or_position": "MANAGER/ PRESIDENT",
        "authorized_official_telephone_number": "214-604-5440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "M3682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mod Lab
• Mode Floss PLLC
• Model Hospice LLC
• Mamatha Modem, M.D
• Modern Enhancement
• Modern Healthcare Services
• Modern Male T-Clinic, P.a.
• Modern Pi LLC
• Modern Research Associates PLLC
• Modern Senior Living LLC

• Gynecology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.