Organization
B RAI MEHTA, MD PA
Active
Other names
South Arlington Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLY ANN IRVING (BILLING MANAGER)
(817) 417-0973
Entity
Organization
Contact information
Practice address
3295 S COOPER ST, 137, ARLINGTON, TX 76015-2363
(817) 417-0973
(817) 417-7266
Mailing address
3295 S COOPER ST, 137, ARLINGTON, TX 76015-2363
(817) 417-0973
(817) 417-7266
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
452592
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
094268201
—
TX
05
—
094268202
—
TX
01
—
HH6225
BLUEE CROSS BLUE SHIELD
TX
Enumeration date
08/03/2006
Last updated
10/09/2008
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