Provider Demographics
NPI:1982613923
Name:DAS, MIHIR (MD)
Entity Type:Individual
Prefix:
First Name:MIHIR
Middle Name:
Last Name:DAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:TX
Mailing Address - Zip Code:75966-3009
Mailing Address - Country:US
Mailing Address - Phone:409-379-2177
Mailing Address - Fax:409-379-2188
Practice Address - Street 1:1304 W COURT ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:TX
Practice Address - Zip Code:75966-3009
Practice Address - Country:US
Practice Address - Phone:409-379-2177
Practice Address - Fax:409-379-2188
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101010207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM2883OtherSTATE LICENSE
TX8G2471Medicare UPIN