Provider Demographics
NPI:1528597580
Name:VIRARKAR, MAYUR KUNDAN
Entity Type:Individual
Prefix:
First Name:MAYUR
Middle Name:KUNDAN
Last Name:VIRARKAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SAIBA, HANUMAN ROAD, KAMAN, VASAI, PALGHAR
Mailing Address - Street 2:
Mailing Address - City:VASAI
Mailing Address - State:MAHARASHTRA
Mailing Address - Zip Code:401208
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1515 HOLCOMBE BLVD UNIT 1459
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4000
Practice Address - Country:US
Practice Address - Phone:713-792-4487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP100589282085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology