Provider Demographics
NPI:1215308713
Name:ATHEM HOSPITALISTS, PLLC
Entity type:Organization
Organization Name:ATHEM HOSPITALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NIRAJ
Authorized Official - Middle Name:MAHENDRA
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-301-4232
Mailing Address - Street 1:3009 PONDER PATH
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-1201
Mailing Address - Country:US
Mailing Address - Phone:817-301-4232
Mailing Address - Fax:
Practice Address - Street 1:3009 PONDER PATH
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-1201
Practice Address - Country:US
Practice Address - Phone:817-301-4232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7482207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176549701Medicaid
TX176549701Medicaid