Healthcare Provider Details

I. General information

NPI: 1932496262
Provider Name (Legal Business Name): DEEPTI VATS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E BRIN ST
TERRELL TX
75160-2938
US

IV. Provider business mailing address

709, CORNELL DRIVE
ROCKWALL TX
75087
US

V. Phone/Fax

Practice location:
  • Phone: 972-524-6452
  • Fax:
Mailing address:
  • Phone: 408-221-7877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberQ7805
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberQ7805
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: