Healthcare Provider Details

I. General information

NPI: 1598764292
Provider Name (Legal Business Name): SAROJA VISWAMITRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 03/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E SAVANNAH AVE STE 10
MCALLEN TX
78503-1727
US

IV. Provider business mailing address

PO BOX 749
PHARR TX
78577-1614
US

V. Phone/Fax

Practice location:
  • Phone: 956-668-9900
  • Fax: 956-668-9902
Mailing address:
  • Phone: 956-362-6680
  • Fax: 956-362-6688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberJ9418
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: