Provider Demographics
NPI:1346851284
Name:BITRA, ANUSHA
Entity Type:Individual
Prefix:
First Name:ANUSHA
Middle Name:
Last Name:BITRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 37TH ST APT 1001
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549-4833
Mailing Address - Country:US
Mailing Address - Phone:270-421-9002
Mailing Address - Fax:
Practice Address - Street 1:5107 COLLEGE AVE STE 2
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549-6277
Practice Address - Country:US
Practice Address - Phone:325-574-1512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36562122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist