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Individual

DR. KAVITA MISTRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
502 E FM 351, BEEVILLE, TX 78102-2208
(361) 362-1666
Mailing address
303 N SHORE RD, MATHIS, TX 78368-4046
(361) 362-1666

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5003TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00E19T
BLUCE CROSS BLUE SHEILD
TX
05
019257701
TX
01
742720948
TAX ID
TX
01
839686
TRICARE
TX
Enumeration date
07/11/2006
Last updated
05/05/2014
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