Physician Compare National (NPI:1386624542)

HEALTHCARE PROVIDER: DALJIT MUTTIANA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1386624542
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3072411743
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20031219000674
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MUTTIANA
	Individual professional last name
Provider First Name	DALJIT
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1977
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	355 SCHOOL ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 101
	Group Practice or individual's line 2 address
City	TOMBALL
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	773754785
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450670
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TOMBALL REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y