Active NPI
Manjula Mittal, M.D
- Family Medicine Physician
- Eagle Pass, TX
National Provider Identifier
1942359773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- F2811
- Practice address
- 2525 N Veterans Blvd
Eagle Pass, TX 78852-3302 - Phone
- (830) 773-5358
- Fax
- (830) 773-0258
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | F2811 | TX | Primary |
Addresses
Primary practice location
2525 N Veterans Blvd
Eagle Pass, TX 78852-3302
Mailing address
P.O.Box111
Eagle Pass, TX 78853
Phone (830) 773-5739
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F2811 | TX | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304380800000",
"number": "1942359773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O.BOX111",
"city": "EAGLE PASS",
"state": "TX",
"postal_code": "78853",
"telephone_number": "830-773-5739",
"fax_number": "830-773-6275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 N VETERANS BLVD",
"city": "EAGLE PASS",
"state": "TX",
"postal_code": "788523302",
"telephone_number": "830-773-5358",
"fax_number": "830-773-0258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITTAL",
"first_name": "MANJULA",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2011-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "F2811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle Pass, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.