Healthcare Provider Details

I. General information

NPI: 1386654887
Provider Name (Legal Business Name): MAYANK A BHATT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAEL A BHATT DC

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 02/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BEARDSLEY LN BLDG B
AUSTIN TX
78746-4945
US

IV. Provider business mailing address

300 BEARDSLEY LN BLDG B
AUSTIN TX
78746-4945
US

V. Phone/Fax

Practice location:
  • Phone: 512-329-5500
  • Fax: 512-329-0170
Mailing address:
  • Phone: 512-329-5500
  • Fax: 512-329-0170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5944
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: