Provider Demographics
NPI:1578923959
Name:GRUH MEDICAL PLLC
Entity Type:Organization
Organization Name:GRUH MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHALIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-637-6383
Mailing Address - Street 1:3601 REGENT BLVD
Mailing Address - Street 2:SUITE 165
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-2290
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3601 REGENT BLVD
Practice Address - Street 2:SUITE 165
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-2290
Practice Address - Country:US
Practice Address - Phone:847-637-6383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX486448Medicare PIN