Mitra, Monalisa M
Mitra, Monalisa M is an sole proprietor health care provider with primary practice located at 4100 Heritage Ave Ste 106, Grapevine TX 76051-5714. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Mitra, Monalisa M can be contacted via phone (817) 283-1112.Contact Information
Primary practice address
4100 Heritage Ave Ste 106
Grapevine TX 76051-5714
Phone: (817) 283-1112
Fax: (817) 283-1116
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | M4363 | Texas |
Profile Details
| NPI number | 1710097456 |
|---|---|
| LBN Legal business name | Mitra, Monalisa M |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Jun 1st, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710097456 | NPPES |
| Texas | MEDICAID | 184283303 | |
| Texas | MEDICAID | 184283302 |
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