Provider Demographics
NPI:1356491336
Name:KATIRA, MULRAJ NARSIDAS (MD)
Entity Type:Individual
Prefix:
First Name:MULRAJ
Middle Name:NARSIDAS
Last Name:KATIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 254
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70527-0254
Mailing Address - Country:US
Mailing Address - Phone:337-788-1733
Mailing Address - Fax:337-788-0028
Practice Address - Street 1:576 N AVENUE G
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-4441
Practice Address - Country:US
Practice Address - Phone:337-788-1733
Practice Address - Fax:337-788-0028
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA014062207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1306576Medicaid
LA52343Medicare PIN
LAB63790Medicare UPIN