Individual
MRUDULA V MEHTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 11TH ST, WICHITA FALLS, TX 76301-4300
(940) 764-7000
Mailing address
3510 N LOOP 1604 E, SAN ANTONIO, TX 78247-2303
(210) 375-7790
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G2431
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114038604
—
TX
01
—
8P6143
BCBSTX
TX
Enumeration date
07/26/2006
Last updated
05/01/2018
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