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NPI Code Detail

MEDICARE: SHRABANEE MITRA MD

MEDICARE: SHRABANEE MITRA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianM2719TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28S6147OTHERTXBCBS

General Provider Information

NPI Number : 1568492288
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHRABANEE MITRA MD
Provider Business Mailing Address
First Line : PO BOX 301173
Second Line :
City : DALLAS
State : TX
Zip : 75303-1173
Country : US
Telephone Number : 713-500-3500
Fax Number :
Provider Business Practice Location Address
First Line : 818 RINGOLD ST
Second Line :
City : HOUSTON
State : TX
Zip : 77088-6368
Country : US
Telephone Number : 281-448-6391
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 08/19/2016

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