Provider Demographics
NPI:1417236837
Name:ABHA MISHRA PLLC
Entity Type:Organization
Organization Name:ABHA MISHRA PLLC
Other - Org Name:GULFPORT SLEEP CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MISHRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:228-452-6121
Mailing Address - Street 1:753 E SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:PASS CHRISTIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39571-4620
Mailing Address - Country:US
Mailing Address - Phone:228-452-6121
Mailing Address - Fax:228-452-6121
Practice Address - Street 1:1110 BROAD AVE STE 600
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-8908
Practice Address - Country:US
Practice Address - Phone:228-284-1656
Practice Address - Fax:228-284-1657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2021-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic