Healthcare Provider Details

I. General information

NPI: 1356505192
Provider Name (Legal Business Name): SANJAY S. BHATIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 N PIEDRAS ST
EL PASO TX
79920-5001
US

IV. Provider business mailing address

5005 N PIEDRAS ST
EL PASO TX
79920-5001
US

V. Phone/Fax

Practice location:
  • Phone: 915-569-2180
  • Fax: 915-569-1919
Mailing address:
  • Phone: 915-569-2180
  • Fax: 915-569-1919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD2015-0901
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01070121A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: