Organization
B RAI MEHTA MD
Active
Other names
Grand Prairie Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY ANN IRVING (BILLING MANAGER)
(817) 417-0973
Entity
Organization
Contact information
Practice address
550 S CARRIER PKWY, 450, GRAND PRAIRIE, TX 75051-1500
(817) 417-0973
(817) 417-7266
Mailing address
550 S CARRIER PKWY, 450, GRAND PRAIRIE, TX 75051-1500
(817) 417-0973
(817) 417-7266
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
007944
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161011501
—
TX
05
—
161011502
—
TX
Enumeration date
08/03/2006
Last updated
06/25/2008
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