Provider Demographics
NPI:1952345704
Name:SARAIYA, MUKESH C (MD)
Entity Type:Individual
Prefix:
First Name:MUKESH
Middle Name:C
Last Name:SARAIYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3200 COLORADO BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6862
Mailing Address - Country:US
Mailing Address - Phone:940-381-0971
Mailing Address - Fax:940-387-2563
Practice Address - Street 1:3200 COLORADO BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6862
Practice Address - Country:US
Practice Address - Phone:940-381-0971
Practice Address - Fax:940-387-2563
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH7503207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80050Medicare ID - Type Unspecified
TXE64957Medicare UPIN