Provider Demographics
NPI:1508142233
Name:MEHTA, DIMPESH (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:DIMPESH
Middle Name:
Last Name:MEHTA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14815 BRIDLE BEND DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084
Mailing Address - Country:US
Mailing Address - Phone:281-814-8304
Mailing Address - Fax:
Practice Address - Street 1:4007 BARKER CYPRESS ROAD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084
Practice Address - Country:US
Practice Address - Phone:281-814-8304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist