Provider Demographics
NPI:1104039916
Name:MISTRY, SANDEEP G (MD)
Entity Type:Individual
Prefix:
First Name:SANDEEP
Middle Name:G
Last Name:MISTRY
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:970 HESTERS CROSSING RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-8027
Mailing Address - Country:US
Mailing Address - Phone:512-238-0762
Mailing Address - Fax:512-341-7370
Practice Address - Street 1:970 HESTERS CROSSING RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-8027
Practice Address - Country:US
Practice Address - Phone:512-238-0762
Practice Address - Fax:512-341-7370
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2011-09-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM0182208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology