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General NPI Number Information
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NPI Number | 1891056164
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Entity Type | Individual
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Provider Name | INDIRA CASSANDRA MAHARAJ-MIKIEL M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2012
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 3347 S 2ND ST
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City | ABILENE
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State | TX
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Zip | 79605-1760
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Country | US
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Telephone | 325-208-3274
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Fax | 325-208-3275
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Provider Business Mailing Address
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Address Line | 3347 S 2ND ST
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City | ABILENE
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State | TX
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Zip | 79605-1760
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Country | US
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Telephone | 325-208-3274
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Fax | 325-208-3275
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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 | 25MA09409100
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License Number State | NJ
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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 | Q9859
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License Number State | TX
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