Provider Demographics
NPI:1023141892
Name:MUKESH SARAIYA MD, PA
Entity type:Organization
Organization Name:MUKESH SARAIYA MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOROODCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-381-0971
Mailing Address - Street 1:3200 COLORADO BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6876
Mailing Address - Country:US
Mailing Address - Phone:940-381-0971
Mailing Address - Fax:940-384-7069
Practice Address - Street 1:3200 COLORADO BLVD STE 200
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6876
Practice Address - Country:US
Practice Address - Phone:940-381-0971
Practice Address - Fax:940-384-7069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7503207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherCOMMERCIAL GROUP NUMBER
TX=========OtherCOMMERCIAL GROUP NUMBER
TX00656KMedicare ID - Type UnspecifiedMEDICARE GROUP