MEDICARE: DR. MUKESH KUMAR D DELVADIYA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	P2430	TX
2	207RH0003X	Hematology & Oncology Physician	P2430	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003070004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUKESH KUMAR D DELVADIYA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 911230
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-1230
Country	:	US
Telephone Number	:	972-997-8000
Fax Number	:	972-234-2987

Provider Business Practice Location Address
First Line	:	6300 W. PARKER ROAD, SUITE 123, MOB II
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-8225
Country	:	US
Telephone Number	:	972-398-2899
Fax Number	:	972-398-2837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2008
Last Update Date	:	03/30/2022

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