Healthcare Provider Details

I. General information

NPI: 1457553794
Provider Name (Legal Business Name): SARIKA BHATNAGAR SHIVNANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARIKA BHATNAGAR

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4708 ALLIANCE BLVD SUITE 300
PLANO TX
75093-5340
US

IV. Provider business mailing address

4708 ALLIANCE BLVD SUITE 300
PLANO TX
75093-5340
US

V. Phone/Fax

Practice location:
  • Phone: 469-800-6000
  • Fax:
Mailing address:
  • Phone: 469-800-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberN9128
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: