Palak Patel, | |
1600 S Brentwood Blvd Ste 700, Brentwood, MO 63144-1304 | |
(314) 367-1181 | |
(314) 968-5117 |
Full Name | Palak Patel |
---|---|
Gender | Female |
Speciality | Ophthalmology - Retina Specialist |
Location | 1600 S Brentwood Blvd Ste 700, Brentwood, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548728033 | NPI | - | NPPES |
036-164218 | Other | IL | MEDICAL LICENSE |
2023011012 | Other | MO | MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207WX0107X | Ophthalmology - Retina Specialist | 036164218 (Illinois) | Secondary |
207WX0107X | Ophthalmology - Retina Specialist | 2023011012 (Missouri) | Primary |
Entity Name | Retina Consultants Ltd |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1700175395 PECOS PAC ID: 9537259957 Enrollment ID: O20110524000146 |
Mailing Address | Practice Location Address |
---|---|
Palak Patel, 8820 Ladue Rd Ste 203, Saint Louis, MO 63124-2080 Ph: (314) 367-1181 | Palak Patel, 1600 S Brentwood Blvd Ste 700, Brentwood, MO 63144-1304 Ph: (314) 367-1181 |
Dr. Mohammad Zia Siddiqui, MD Ophthalmology Medicare: Medicare Enrolled Practice Location: 1600 S Brentwood Blvd Ste 700, Brentwood, MO 63144 Phone: 314-367-1181 | |
Rui Wang, MD Ophthalmology Medicare: Medicare Enrolled Practice Location: 1600 S Brentwood Blvd Ste 700, Brentwood, MO 63144 Phone: 314-367-1181 | |
Thomas K Krummenacher, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1600 S Brentwood Blvd Ste 700, Brentwood, MO 63144 Phone: 314-367-1181 Fax: 314-968-5117 | |
Dr. Ollya V. Fromal, MD Ophthalmology Medicare: Medicare Enrolled Practice Location: 1600 S Brentwood Blvd Ste 700, Brentwood, MO 63144 Phone: 314-367-1181 | |
Dr. Barton Blackorby, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1600 S Brentwood Blvd Ste 700, Brentwood, MO 63144 Phone: 314-367-1181 | |
Richard Joseph Rothman, MD Ophthalmology Medicare: Medicare Enrolled Practice Location: 1600 S Brentwood Blvd Ste 700, Brentwood, MO 63144 Phone: 314-367-1181 Fax: 314-968-5117 |