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General NPI Number Information
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NPI Number | 1205372018
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Entity Type | Individual
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Provider Name | NITIN P BHANTI LCO
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Gender | Male
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Dates
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Enumeration Date | 01/18/2017
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 13 PRESTIGE CIR STE 180
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City | ALLEN
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State | TX
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Zip | 75002-3453
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Country | US
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Telephone | 214-596-9508
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Fax | 214-596-9147
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Provider Business Mailing Address
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Address Line | PO BOX 99283
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City | FORT WORTH
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State | TX
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Zip | 76199-1383
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Country | US
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Telephone | 682-885-6294
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Fax | 682-885-5606
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | 1840
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License Number State | TX
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