Provider Demographics
NPI:1063961050
Name:MEHTA, YESHA (PT)
Entity type:Individual
Prefix:
First Name:YESHA
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:YESHA
Other - Middle Name:
Other - Last Name:PANDYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8121 FOUNTAIN SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3996
Mailing Address - Country:US
Mailing Address - Phone:806-283-7991
Mailing Address - Fax:
Practice Address - Street 1:8121 FOUNTAIN SPRINGS DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3996
Practice Address - Country:US
Practice Address - Phone:806-283-7991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-01
Last Update Date:2022-01-17
Deactivation Date:2018-05-01
Deactivation Code:
Reactivation Date:2022-01-17
Provider Licenses
StateLicense IDTaxonomies
TX1238627225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist