Healthcare Provider Details

I. General information

NPI: 1144619370
Provider Name (Legal Business Name): BHUPESH H DIHENIA, MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2015
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 23RD ST
LUBBOCK TX
79410-1809
US

IV. Provider business mailing address

3815 23RD ST
LUBBOCK TX
79410-1809
US

V. Phone/Fax

Practice location:
  • Phone: 806-722-3500
  • Fax: 806-796-0689
Mailing address:
  • Phone: 806-722-3500
  • Fax: 806-796-0689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: DR. BHUPESH H DIHENIA
Title or Position: OWNER
Credential: M.D.
Phone: 806-722-3500