Healthcare Provider Details

I. General information

NPI: 1801158373
Provider Name (Legal Business Name): KRITI MOHAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 08/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 GESSNER RD STE 2250
HOUSTON TX
77024
US

IV. Provider business mailing address

929 GESSNER RD STE 2250
HOUSTON TX
77024-2664
US

V. Phone/Fax

Practice location:
  • Phone: 713-633-4411
  • Fax:
Mailing address:
  • Phone: 713-633-4411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberR0910
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberBP10043207
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: