Provider Demographics
NPI:1215958624
Name:KHAMBATI, MUNIRA A (MD)
Entity type:Individual
Prefix:DR
First Name:MUNIRA
Middle Name:A
Last Name:KHAMBATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MUNIRA
Other - Middle Name:
Other - Last Name:CHHATRIWALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1219
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-7219
Mailing Address - Country:US
Mailing Address - Phone:830-693-2600
Mailing Address - Fax:830-693-9756
Practice Address - Street 1:1009 FALLS PKWY STE C
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-4630
Practice Address - Country:US
Practice Address - Phone:830-693-2600
Practice Address - Fax:830-693-9756
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5407207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX355821501Medicaid
TX261502YXUFMedicare PIN