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NPI Code Detail

MEDICARE: DR. PAVANI BELLARY D.O.

MEDICARE: DR. PAVANI BELLARY D.O.
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
1207R00000XInternal Medicine PhysicianL8281TX

General Provider Information

NPI Number : 1841297330
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAVANI BELLARY D.O.
Provider Business Mailing Address
First Line : PO BOX 12056
Second Line :
City : FORT WORTH
State : TX
Zip : 76110-8056
Country : US
Telephone Number : 682-268-1152
Fax Number : 817-818-1766
Provider Business Practice Location Address
First Line : 2260 COLLEGE AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76110-1952
Country : US
Telephone Number : 682-268-1152
Fax Number : 817-818-1766
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 09/11/2020

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Directions to “ DR. PAVANI BELLARY D.O.” Practice Location

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