Provider Demographics
NPI:1235175076
Name:MEHTA, RITU (DC)
Entity Type:Individual
Prefix:DR
First Name:RITU
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 W. PARK BLVD SUITE 306
Mailing Address - Street 2:PMB 376
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:972-316-3344
Mailing Address - Fax:972-316-3322
Practice Address - Street 1:1850 LAKEPOINTE SUITE 100
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057
Practice Address - Country:US
Practice Address - Phone:972-316-3344
Practice Address - Fax:972-316-3322
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R0540OtherBLUE CROSS
TX8B6684Medicare ID - Type Unspecified
TXU98992Medicare UPIN