Healthcare Provider Details

I. General information

NPI: 1528649175
Provider Name (Legal Business Name): MONJIRA BISWAS CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 MUELLER BLVD
AUSTIN TX
78723-3079
US

IV. Provider business mailing address

3607 S LAMAR BLVD APT 1462
AUSTIN TX
78704-0393
US

V. Phone/Fax

Practice location:
  • Phone: 855-324-0091
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1022079
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: