Provider Demographics
NPI:1760686695
Name:KASHI S BAGRI MD PA
Entity Type:Organization
Organization Name:KASHI S BAGRI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KASHI
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAGRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-898-8820
Mailing Address - Street 1:2194A EASTEX FWY
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77703-4939
Mailing Address - Country:US
Mailing Address - Phone:409-898-8820
Mailing Address - Fax:409-899-3434
Practice Address - Street 1:2194A EASTEX FWY
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77703-4939
Practice Address - Country:US
Practice Address - Phone:409-898-8820
Practice Address - Fax:409-899-3434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF34022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0094RAOtherBCBS
TX260001005OtherMEDICARE RAILROAD
4343827OtherAETNA
TX128409301Medicaid
TX00Z915Medicare PIN
TXB21058Medicare UPIN