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General NPI Number Information
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NPI Number | 1033671219
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Entity Type | Individual
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Provider Name | MITRA SALIGHEDAR DOTY DO
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Gender | Female
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 4264 STATE HIGHWAY 66 STE A
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City | CADDO MILLS
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State | TX
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Zip | 75135-6270
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Country | US
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Telephone | 903-408-5000
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Fax | 469-902-9551
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Provider Business Mailing Address
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Address Line | 501 AIR PARK AVE
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City | GREENVILLE
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State | TX
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Zip | 75402-3000
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Country | US
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Telephone | 903-408-5834
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Fax | 903-408-5693
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | V0382
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.015666
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License Number State | OH
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