| Shivrudra PLLC | |
|
4441 Long Prairie Rd Ste 100 Flower Mound TX 75028-5410 | |
| (469) 933-2253 | |
| (469) 933-2254 |
| Full Name | Shivrudra PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 4441 Long Prairie Rd Ste 100, Flower Mound, Texas |
| Authorized Official Name and Position | Mehul Shah (CEO) |
| Authorized Official Contact | 8177895044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shivrudra PLLC 1111 Terrace Dr Lantana TX 76226-6672 Ph: (817) 789-5044 | Shivrudra PLLC 4441 Long Prairie Rd Ste 100 Flower Mound TX 75028-5410 Ph: (469) 933-2253 |
| NPI Number | 1841091360 |
|---|---|
| Provider Enumeration Date | 03/20/2025 |
| Last Update Date | 03/20/2025 |
| Certification Date | 03/20/2025 |
| Medicare PECOS PAC ID | 4981121712 |
|---|---|
| Medicare Enrollment ID | O20250506001492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841091360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | () | Primary |
| Provider Name | Mehul P Shah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184036378 PECOS PAC ID: 4880986793 Enrollment ID: I20231222001738 |
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