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General NPI Number Information
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NPI Number | 1043873128
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Entity Type | Individual
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Provider Name | GINA MAHATMA
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Gender | Female
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | DEAN MCGEE EYE INSTITUTE, 608 STANTON L. YOUNG BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104
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Country | US
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Telephone | 405-271-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 W ROYAL LN STE 200
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City | IRVING
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State | TX
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Zip | 75063-3232
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Country | US
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Telephone | 972-331-1599
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 322431
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License Number State | NY
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