MEDICARE: MUCLIDHAR A. AMIN, MD, PA

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	207RC0000X	Cardiovascular Disease Physician	J7888	TX

General Provider Information

NPI Number	:	1811993439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUCLIDHAR A. AMIN, MD, PA

Provider Business Mailing Address
First Line	:	PO BOX 26018 DEPT 8056
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77720-8056
Country	:	US
Telephone Number	:	409-729-0885
Fax Number	:	409-729-2696

Provider Business Practice Location Address
First Line	:	2300 HIGHWAY 365
Second Line	:	STE 150
City	:	NEDERLAND
State	:	TX
Zip	:	77627-6293
Country	:	US
Telephone Number	:	409-729-0885
Fax Number	:	409-729-2696

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MURLIDHAR ANANTKUMAR AMIN
Credential	:	MD
Telephone Number	:	409-729-0885

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	08/22/2020

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