Provider Demographics
NPI:1821277708
Name:VIKRAM MEHRA M.D.,P.A.
Entity Type:Organization
Organization Name:VIKRAM MEHRA M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIKRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-777-9900
Mailing Address - Street 1:21613 PROVINCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6506
Mailing Address - Country:US
Mailing Address - Phone:713-777-9900
Mailing Address - Fax:713-777-9902
Practice Address - Street 1:21613 PROVINCIAL BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6506
Practice Address - Country:US
Practice Address - Phone:713-777-9900
Practice Address - Fax:713-777-9902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ65912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164440302Medicaid
TXG05444Medicare UPIN
TX00476TMedicare PIN