| Nimisha Mehta Md Pa | |
|
860 Hebron Pkwy Ste 401 Lewisville TX 75057-5143 | |
| (469) 916-6641 | |
| (469) 322-4175 |
| Full Name | Nimisha Mehta Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 860 Hebron Pkwy Ste 401, Lewisville, Texas |
| Authorized Official Name and Position | Nimisha Mehta (MANAGING MEMBER) |
| Authorized Official Contact | 4699166641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nimisha Mehta Md Pa 860 Hebron Pkwy Ste 401 Lewisville TX 75057-5143 Ph: (469) 916-6641 | Nimisha Mehta Md Pa 860 Hebron Pkwy Ste 401 Lewisville TX 75057-5143 Ph: (469) 916-6641 |
| NPI Number | 1346472362 |
|---|---|
| Provider Enumeration Date | 08/10/2009 |
| Last Update Date | 12/27/2010 |
| Medicare PECOS PAC ID | 5395881262 |
|---|---|
| Medicare Enrollment ID | O20091006000721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346472362 | NPI | - | NPPES |
| 0084SV | Other | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Nimisha A Mehta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699783696 PECOS PAC ID: 8921994393 Enrollment ID: I20040223001333 |
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