Provider Demographics
NPI:1558527747
Name:MESTRY, KAUSTUBH SUDHIR (MD)
Entity Type:Individual
Prefix:DR
First Name:KAUSTUBH
Middle Name:SUDHIR
Last Name:MESTRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1001 W ARBROOK BLVD STE 161
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-4222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 W ARBROOK BLVD STE 161
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-4222
Practice Address - Country:US
Practice Address - Phone:817-402-0952
Practice Address - Fax:817-402-4773
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5867207Q00000X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine