Healthcare Provider Details

I. General information

NPI: 1205326006
Provider Name (Legal Business Name): PARTH J BHAKTA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2018
Last Update Date: 11/10/2022
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number3089
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: