MEDICARE: DR. HEMA GIRISH MISTRY OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	6718TG	TX

General Provider Information

NPI Number	:	1013013507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEMA GIRISH MISTRY OD

Provider Business Mailing Address
First Line	:	2046 N SHILOH RD
Second Line	:	112
City	:	GARLAND
State	:	TX
Zip	:	75044-7866
Country	:	US
Telephone Number	:	713-384-9513
Fax Number	:

Provider Business Practice Location Address
First Line	:	2046 N SHILOH RD
Second Line	:	112
City	:	GARLAND
State	:	TX
Zip	:	75044-7866
Country	:	US
Telephone Number	:	713-384-9513
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	07/08/2007

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