MEDICARE: DR. MUKESH N. MEHTA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	K8338	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00U65J	OTHER	TX	GROUP MCARE ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558361188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUKESH N. MEHTA M.D.

Provider Business Mailing Address
First Line	:	1331 W. GRAND PARKWAY NORTH
Second Line	:	SUITE 230
City	:	KATY
State	:	TX
Zip	:	77493-2711
Country	:	US
Telephone Number	:	281-392-8620
Fax Number	:	281-392-2258

Provider Business Practice Location Address
First Line	:	1331 W. GRAND PARKWAY NORTH
Second Line	:	SUITE 230
City	:	KATY
State	:	TX
Zip	:	77493-2711
Country	:	US
Telephone Number	:	281-392-8620
Fax Number	:	281-392-2258

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	12/17/2010

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