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NPI Code Detail

MEDICARE: DR. ACHAL PANKAJ MODI MD

MEDICARE: DR. ACHAL PANKAJ MODI MD
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
1208800000XUrology Physician57012170OH
2208800000XUrology PhysicianN9270TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255540514
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ACHAL PANKAJ MODI MD
Provider Business Mailing Address
First Line : 4440 E HIGHWAY 287
Second Line :
City : MIDLOTHIAN
State : TX
Zip : 76065-5576
Country : US
Telephone Number : 972-938-8526
Fax Number : 972-709-5920
Provider Business Practice Location Address
First Line : 4440 E HIGHWAY 287
Second Line :
City : MIDLOTHIAN
State : TX
Zip : 76065-5576
Country : US
Telephone Number : 972-938-8526
Fax Number : 972-709-5920
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 11/26/2019

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Directions to “ DR. ACHAL PANKAJ MODI MD” Practice Location

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