Healthcare Provider Details

I. General information

NPI: 1437471257
Provider Name (Legal Business Name): CHIRAG V MEHTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 E PRESIDENT GEORGE BUSH HWY STE 101
RICHARDSON TX
75082
US

IV. Provider business mailing address

3201 E. PRESIDENT GEORGE BUSH HWY. STE. 101
RICHARDSON TX
75082
US

V. Phone/Fax

Practice location:
  • Phone: 972-470-5000
  • Fax:
Mailing address:
  • Phone: 972-470-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberP5209
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: