MEDICARE: DR. DHARMESH P BHAKTA D.P.M

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	1600	TX

General Provider Information

NPI Number	:	1346243243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DHARMESH P BHAKTA D.P.M

Provider Business Mailing Address
First Line	:	3050 S CENTER ST
Second Line	:	SUITE 140
City	:	ARLINGTON
State	:	TX
Zip	:	76014-2022
Country	:	US
Telephone Number	:	817-557-1006
Fax Number	:	817-557-2000

Provider Business Practice Location Address
First Line	:	3050 S CENTER ST
Second Line	:	SUITE 140
City	:	ARLINGTON
State	:	TX
Zip	:	76014-2022
Country	:	US
Telephone Number	:	817-557-1006
Fax Number	:	817-557-2000

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	11/20/2015

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