Individual
AJAY KUMAR MISHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 HILLCREST MEDICAL BLVD, WACO, TX 76712
(254) 202-2000
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
939667
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP138121
TX
Other
Enumeration date
04/30/2018
Last updated
07/11/2022
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