Provider Demographics
NPI:1275985129
Name:SAUMIL MEHTA MD PLLC
Entity Type:Organization
Organization Name:SAUMIL MEHTA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAUMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-267-1988
Mailing Address - Street 1:6404 INTERNATIONAL PKWY STE 1010
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8346
Mailing Address - Country:US
Mailing Address - Phone:972-267-1988
Mailing Address - Fax:972-267-3434
Practice Address - Street 1:6404 INTERNATIONAL PKWY
Practice Address - Street 2:SUITE #2100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8225
Practice Address - Country:US
Practice Address - Phone:972-267-1988
Practice Address - Fax:972-267-3434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-04
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3013207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098858603Medicaid
TX8B6091Medicare Oscar/Certification
TXF44943Medicare UPIN