Individual
DURBA MISHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1273 S PEACHTREE ST, JASPER, TX 75951-4915
(409) 384-9200
(409) 384-9205
Mailing address
1273 S PEACHTREE ST, JASPER, TX 75951-4915
(409) 384-9200
(409) 384-9205
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
L0429
TX
207R00000X
Internal Medicine Physician
Primary
L0429
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031495701
—
TX
05
—
031495705
—
TX
Enumeration date
08/05/2006
Last updated
09/12/2023
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