Healthcare Provider Details

I. General information

NPI: 1558776765
Provider Name (Legal Business Name): MEETA BHALLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 E 11TH ST
AUSTIN TX
78702-2709
US

IV. Provider business mailing address

1705 E 11TH ST
AUSTIN TX
78702-2709
US

V. Phone/Fax

Practice location:
  • Phone: 512-978-8400
  • Fax:
Mailing address:
  • Phone: 512-978-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberU3789
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number56189
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: