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Individual
VISWAJYOTHI MAMBAPOOR
Active
Individual
VISWAJYOTHI MAMBAPOOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
L1124
TX
207R00000X
Internal Medicine Physician
Primary
L1124
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146610401
—
TX
Enumeration date
09/15/2006
Last updated
10/29/2019
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