Provider Demographics
NPI:1497913800
Name:MEHTA, ANKUR D (DO)
Entity Type:Individual
Prefix:
First Name:ANKUR
Middle Name:D
Last Name:MEHTA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8830 LONG POINT RD
Mailing Address - Street 2:SUITE: 502
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-3040
Mailing Address - Country:US
Mailing Address - Phone:832-849-0909
Mailing Address - Fax:
Practice Address - Street 1:8830 LONG POINT RD
Practice Address - Street 2:SUITE 502
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3040
Practice Address - Country:US
Practice Address - Phone:832-849-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0097208100000X, 2081S0010X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB145538Medicare PIN