Provider Demographics
NPI:1912375288
Name:MOHAPATRA, DIKSHA (DPM)
Entity type:Individual
Prefix:
First Name:DIKSHA
Middle Name:
Last Name:MOHAPATRA
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UT SOUTHWESTERN MEDICAL CENTER
Mailing Address - Street 2:5323 HARRY HINES BOULEVARD
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UT SOUTHWESTERN MEDICAL CENTER
Practice Address - Street 2:5323 HARRY HINES BOULEVARD
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390
Practice Address - Country:US
Practice Address - Phone:214-648-3433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2025-03-24
Deactivation Date:2022-03-24
Deactivation Code:
Reactivation Date:2022-04-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health