Provider Demographics
NPI:1487850046
Name:MISRA, LOTIKA REENA (MD)
Entity Type:Individual
Prefix:DR
First Name:LOTIKA
Middle Name:REENA
Last Name:MISRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W 38TH ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6400
Mailing Address - Country:US
Mailing Address - Phone:512-324-3540
Mailing Address - Fax:512-324-3541
Practice Address - Street 1:5103 KYLE CENTER DR
Practice Address - Street 2:SUITE 103
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6163
Practice Address - Country:US
Practice Address - Phone:512-324-3540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN09872084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197092301Medicaid
TX1970952302Medicaid
TX197092303Medicaid
TXP00805530OtherRRMCR
TX197092301Medicaid
TX1970952302Medicaid
TX343607YMGJMedicare PIN