Healthcare Provider Details

I. General information

NPI: 1588011753
Provider Name (Legal Business Name): MOKSH MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2016
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WOUND CARE CENTER 7 MEDICAL PKWY
DALLAS TX
75234-7829
US

IV. Provider business mailing address

11700 LEBANON RD APT 2026R
FRISCO TX
75035-8287
US

V. Phone/Fax

Practice location:
  • Phone: 469-453-8118
  • Fax: 972-888-7047
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAJIVKUMAR G AMIPARA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 469-453-8118