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General NPI Number Information
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NPI Number | 1386651818
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Entity Type | Individual
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Provider Name | MAHESH R DAVE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 1201D BRIARCREST DR
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City | BRYAN
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State | TX
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Zip | 77802-5223
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Country | US
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Telephone | 979-776-5600
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Fax | 979-776-6280
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Provider Business Mailing Address
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Address Line | 1201D BRIARCREST DR
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City | BRYAN
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State | TX
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Zip | 77802-5223
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Country | US
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Telephone | 979-776-5600
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Fax | 979-704-5461
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | F8457
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License Number State | TX
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