Healthcare Provider Details

I. General information

NPI: 1114051463
Provider Name (Legal Business Name): DHARMESH BHAKTA, DPM, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 S CENTER ST STE 140
ARLINGTON TX
76014
US

IV. Provider business mailing address

3050 S CENTER ST STE 140
ARLINGTON TX
76014-2155
US

V. Phone/Fax

Practice location:
  • Phone: 817-557-1006
  • Fax: 817-557-2000
Mailing address:
  • Phone: 817-557-1006
  • Fax: 817-557-2000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: SHEILA SUMMERS
Title or Position: ADMINISTRATOR
Credential:
Phone: 817-557-1006