1093383358 NPI number — UNKNOWN ANUJA MAHESH MISTRY MD

Table of content: UNKNOWN ANUJA MAHESH MISTRY MD (NPI 1093383358)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093383358 NPI number — UNKNOWN ANUJA MAHESH MISTRY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANUJA MAHESH MISTRY
Provider First Name:
UNKNOWN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MISTRY
Provider Other First Name:
ANUJA
Provider Other Middle Name:
MAHESH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1093383358
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000B TRANSMOUNTAIN RD STE 400I
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79911-3600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-215-8495
Provider Business Mailing Address Fax Number:
915-215-8671

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000B TRANSMOUNTAIN RD STE 400I
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79911-3600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-215-8495
Provider Business Practice Location Address Fax Number:
915-215-8671
Provider Enumeration Date:
06/14/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  70741 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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