Provider Demographics
NPI:1831729987
Name:MAHADIK, RIYUSHHI
Entity type:Individual
Prefix:
First Name:RIYUSHHI
Middle Name:
Last Name:MAHADIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 FM 973
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-4540
Mailing Address - Country:US
Mailing Address - Phone:512-676-8213
Mailing Address - Fax:
Practice Address - Street 1:1530 FM 973
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-4540
Practice Address - Country:US
Practice Address - Phone:512-676-8213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA14830363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant