Individual
ANIRBAN MAITRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.B.B.S.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
D57031
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329093401 (MDACC)
—
TX
05
—
61503000
—
MD
01
—
8DY719
BCBS (MDACC)
TX
Enumeration date
06/11/2006
Last updated
05/08/2014
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