Provider Demographics
NPI:1669654398
Name:COMPREHENSIVE ORTHOPAEDICS & REHABILITATION, P.A.
Entity Type:Organization
Organization Name:COMPREHENSIVE ORTHOPAEDICS & REHABILITATION, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SACHEEN
Authorized Official - Middle Name:HASMUKH
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-575-2663
Mailing Address - Street 1:1120 W CAMPBELL RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2976
Mailing Address - Country:US
Mailing Address - Phone:214-575-2663
Mailing Address - Fax:214-575-2664
Practice Address - Street 1:1120 W CAMPBELL RD
Practice Address - Street 2:SUITE 109
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2976
Practice Address - Country:US
Practice Address - Phone:214-575-2663
Practice Address - Fax:214-575-2664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2467207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148878501Medicaid
TX5568860001Medicare NSC
TX148878501Medicaid