=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518626431
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MERAK HEALTH PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2021
-----------------------------------------------------
Last Update Date | 05/06/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2504 RIDGE RD STE 203
-----------------------------------------------------
City | ROCKWALL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75087-2571
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-588-4833
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2504 RIDGE RD STE 203
-----------------------------------------------------
City | ROCKWALL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75087-2571
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-588-4833
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. AKHIL DEV VATS
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 408-221-0918
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QA0505X
-----------------------------------------------------
Taxonomy Name | Adult Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------