Provider Demographics
NPI:1003070004
Name:DELVADIYA, MUKESH KUMAR D (MD)
Entity Type:Individual
Prefix:DR
First Name:MUKESH KUMAR
Middle Name:D
Last Name:DELVADIYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:6300 W. PARKER ROAD, SUITE 123, MOB II
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8225
Practice Address - Country:US
Practice Address - Phone:972-398-2899
Practice Address - Fax:972-398-2837
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2430207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX343247805Medicaid
OK200962360AMedicaid