MEDICARE: ARUN KUMAR MUKHOPADHYAY M.D.

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	174400000X	Specialist	E 1909	TX
2	207RG0100X	Gastroenterology Physician	E1909	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	E1909	OTHER	TX	LICENSE
2	76-0005931	OTHER	TX	TAX IDENTIFICATION
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295728525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARUN KUMAR MUKHOPADHYAY M.D.

Provider Business Mailing Address
First Line	:	11914 ASTORIA BLVD
Second Line	:	STE 580
City	:	HOUSTON
State	:	TX
Zip	:	77089-6064
Country	:	US
Telephone Number	:	281-424-1253
Fax Number	:	281-481-1205

Provider Business Practice Location Address
First Line	:	11914 ASTORIA BLVD
Second Line	:	STE 580
City	:	HOUSTON
State	:	TX
Zip	:	77089-6064
Country	:	US
Telephone Number	:	281-424-1253
Fax Number	:	281-481-1205

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	03/23/2016

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