Provider Demographics
NPI:1891972881
Name:KAVITA MISTRY O.D.,P.A
Entity Type:Organization
Organization Name:KAVITA MISTRY O.D.,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAVITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MISTRY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:361-362-1666
Mailing Address - Street 1:502 E FM 351
Mailing Address - Street 2:
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102-2208
Mailing Address - Country:US
Mailing Address - Phone:361-362-1666
Mailing Address - Fax:361-362-1163
Practice Address - Street 1:502 E FM 351
Practice Address - Street 2:
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-2208
Practice Address - Country:US
Practice Address - Phone:361-362-1666
Practice Address - Fax:361-362-1163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5003TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty