Provider Demographics
NPI:1336569052
Name:MEHTA, RICKY C (MD)
Entity Type:Individual
Prefix:
First Name:RICKY
Middle Name:C
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6210 E HIGHWAY 290
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-406-6216
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:4100 EVERETT DR STE 400
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6147
Practice Address - Country:US
Practice Address - Phone:512-295-1333
Practice Address - Fax:512-406-7327
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2021-07-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
TXS0741207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program