Provider Demographics
NPI:1235220468
Name:MEKHAIL, MOUNIR (MD)
Entity Type:Individual
Prefix:
First Name:MOUNIR
Middle Name:
Last Name:MEKHAIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4112 RYAN LN
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3752
Mailing Address - Country:US
Mailing Address - Phone:214-499-1535
Mailing Address - Fax:972-957-2640
Practice Address - Street 1:4112 RYAN LN
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3752
Practice Address - Country:US
Practice Address - Phone:214-499-1535
Practice Address - Fax:972-957-2640
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2154207L00000X, 208VP0014X, 207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F6331OtherBLUE CROSS
TX8DC360OtherBCBS
TX8DC360OtherBCBS
TX8DC360OtherBCBS
TX8F6331OtherBLUE CROSS
TXB24840Medicare UPIN
TXP084053K4Medicaid
TX8B6782Medicare PIN
TXTXB161306Medicare PIN