MEDICARE: MRS. KASHI S BAGRI 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
1	2084P0805X	Geriatric Psychiatry Physician	F3402	TX
2	2084P0800X	Psychiatry Physician	F3402	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	260001005	OTHER	TX	PALMETTO RAILROAD MEDICAR
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	00MH88	OTHER	TX	BLUE CROSS BLUE SHIELD
4	760026581	OTHER	TX	COMMERICAL

General Provider Information

NPI Number	:	1730166075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KASHI S BAGRI MD

Provider Business Mailing Address
First Line	:	2194A EASTEX FWY
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77703-4939
Country	:	US
Telephone Number	:	409-898-8820
Fax Number	:	409-899-3434

Provider Business Practice Location Address
First Line	:	2194A EASTEX FWY
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77703-4939
Country	:	US
Telephone Number	:	409-898-8820
Fax Number	:	409-899-3434

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	10/20/2021

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Directions to “ MRS. KASHI S BAGRI MD” Practice Location

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