Healthcare Provider Details

I. General information

NPI: 1609055771
Provider Name (Legal Business Name): CHARUTA NARAYAN JOSHI MBBS, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHARUTA ABHAY DIVEKAR

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 HARRY HINES BLVD
DALLAS TX
75390-7106
US

IV. Provider business mailing address

PO BOX 845347
DALLAS TX
75284-5347
US

V. Phone/Fax

Practice location:
  • Phone: 214-648-3111
  • Fax:
Mailing address:
  • Phone: 214-590-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberT4534
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberT4534
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number37486
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberDR.0056782
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: