Basic Information
| Provider Information | |||||||||
| NPI: | 1275985129 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAUMIL MEHTA MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6404 INTERNATIONAL PKWY STE 1010 | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750938346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722671988 | ||||||||
| FaxNumber: | 9722673434 | ||||||||
| Practice Location | |||||||||
| Address1: | 6404 INTERNATIONAL PKWY | ||||||||
| Address2: | SUITE #2100 | ||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750938225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722671988 | ||||||||
| FaxNumber: | 9722673434 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2016 | ||||||||
| LastUpdateDate: | 02/26/2021 | ||||||||
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| AuthorizedOfficialLastName: | MEHTA | ||||||||
| AuthorizedOfficialFirstName: | SAUMIL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9722671988 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 02/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RA0000X | J3013 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Adolescent Medicine |
ID Information
| ID | Type | State | Issuer | Description | 098858603 | 05 | TX | MEDICAID |