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General NPI Number Information
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NPI Number | 1750725131
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Entity Type | Organization
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Legal Business Name | WOMANS CLINIC AT LIVINGSTON PLLC
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Dates
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Enumeration Date | 04/29/2013
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Last Update Date | 05/20/2013
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Provider Practice Location Address
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Address Line | 111 EMERGENCY DR. STE C
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City | LIVINGSTON
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State | TX
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Zip | 77351
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Country | US
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Telephone | 817-570-7300
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Fax | 817-570-7062
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Provider Business Mailing Address
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Address Line | 4100 INTERNATIONAL PLZ STE 240
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City | FORT WORTH
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State | TX
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Zip | 76109-4820
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Country | US
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Telephone | 817-570-7300
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Fax | 817-570-7062
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Authorized Official
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Title or Position | MANAGER
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Name | DR. MAHESH SHETTY
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Credential | MD
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Telephone | 817-570-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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