MEDICARE: PURVI JAI SANGHVI 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	24018	OK
2	207R00000X	Internal Medicine Physician	N0432	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

General Provider Information

NPI Number	:	1356495857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PURVI JAI SANGHVI M.D.

Provider Business Mailing Address
First Line	:	3783 S LAKE FOREST DR STE 100
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-1913
Country	:	US
Telephone Number	:	972-808-7111
Fax Number	:	972-548-7112

Provider Business Practice Location Address
First Line	:	3783 S LAKE FOREST DR STE 100
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-1913
Country	:	US
Telephone Number	:	972-808-7111
Fax Number	:	972-548-7112

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	11/23/2021

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