Provider Demographics
NPI:1982612040
Name:MEHTA, SEJAL S (MD)
Entity Type:Individual
Prefix:
First Name:SEJAL
Middle Name:S
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6404 INTERNATIONAL PARKWAY
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8228
Mailing Address - Country:US
Mailing Address - Phone:972-267-1988
Mailing Address - Fax:972-267-3434
Practice Address - Street 1:6404 INTERNATIONAL PARKWAY
Practice Address - Street 2:SUITE 2100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8228
Practice Address - Country:US
Practice Address - Phone:972-267-1988
Practice Address - Fax:972-267-3434
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL88352084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH30915Medicare UPIN
TX611270Medicare ID - Type Unspecified