Provider Demographics
NPI:1760477236
Name:MAHESHWARI, MUKUL P (MD)
Entity Type:Individual
Prefix:
First Name:MUKUL
Middle Name:P
Last Name:MAHESHWARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7200 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4202
Mailing Address - Country:US
Mailing Address - Phone:713-798-2400
Mailing Address - Fax:
Practice Address - Street 1:4005 24TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1815
Practice Address - Country:US
Practice Address - Phone:806-792-2767
Practice Address - Fax:888-861-8858
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK51442085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX047908101Medicaid
89R066Medicare ID - Type Unspecified