Provider Demographics
NPI:1932228277
Name:RAJESH M MEHTA MD INC
Entity Type:Organization
Organization Name:RAJESH M MEHTA MD INC
Other - Org Name:CENTRAL TEXAS GASTROENTEROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:M
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-732-8992
Mailing Address - Street 1:5656 BEE CAVE RD
Mailing Address - Street 2:SUITE D205
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5280
Mailing Address - Country:US
Mailing Address - Phone:512-732-8992
Mailing Address - Fax:304-242-7108
Practice Address - Street 1:5656 BEE CAVE RD
Practice Address - Street 2:SUITE D205
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5280
Practice Address - Country:US
Practice Address - Phone:512-732-8992
Practice Address - Fax:304-242-7108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0854384Medicaid
DF8863OtherRR MEDCR
1434905OtherUMWA
DF8863OtherRR MEDCR
OH9348211Medicare PIN
F08242Medicare UPIN