Individual
ANIRBAN P MITRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
152449
CA
208800000X
Urology Physician
S5994
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418026701
—
TX
01
—
418026702
CSHCN MEDICAID TPI
TX
Enumeration date
01/11/2017
Last updated
05/27/2025
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