Healthcare Provider Details

I. General information

NPI: 1629015375
Provider Name (Legal Business Name): YOGISH D KAMATH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 KELL BLVD
WICHITA FALLS TX
76308-1523
US

IV. Provider business mailing address

3939 KELL BLVD
WICHITA FALLS TX
76308-1523
US

V. Phone/Fax

Practice location:
  • Phone: 940-341-2767
  • Fax: 940-689-9662
Mailing address:
  • Phone: 940-341-2767
  • Fax: 940-689-9662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberN6405
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: