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1629074208

NPI Code Detail

MEDICARE: MUKESH R. SHETH MD

MEDICARE: MUKESH R. SHETH 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
1	207RI0011X	Interventional Cardiology Physician	H5061	TX
2	207R00000X	Internal Medicine Physician	H5061	TX
3	207RC0000X	Cardiovascular Disease Physician	H5061	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	16625	OTHER	OK	MEDICAL LICENSURE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629074208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUKESH R. SHETH MD

Provider Business Mailing Address
First Line	:	5012 S US HIGHWAY 75 STE 300
Second Line	:	ATT. BILLING
City	:	DENSION
State	:	TX
Zip	:	75020-4589
Country	:	US
Telephone Number	:	903-465-3624
Fax Number	:	903-465-3973

Provider Business Practice Location Address
First Line	:	5026 POOL ROAD
Second Line	:
City	:	DENISON
State	:	TX
Zip	:	75020-4595
Country	:	US
Telephone Number	:	903-465-3624
Fax Number	:	903-465-3973

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	10/09/2017

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Directions to “ MUKESH R. SHETH MD” Practice Location

Language	Start Address	Practice Location

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