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General NPI Number Information
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NPI Number | 1255612784
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Entity Type | Organization
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Legal Business Name | SHEETAL BHAGA PATEL O.D., PLLC
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Dates
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Enumeration Date | 08/29/2011
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Last Update Date | 08/29/2011
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Provider Practice Location Address
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Address Line | 2630 N JOSEY LN SUITE 113
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City | CARROLLTON
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State | TX
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Zip | 75007-5545
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Country | US
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Telephone | 972-242-6392
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Fax | 972-242-5398
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Provider Business Mailing Address
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Address Line | 2630 N JOSEY LN SUITE 113
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City | CARROLLTON
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State | TX
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Zip | 75007-5545
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Country | US
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Telephone | 972-242-6392
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Fax | 972-242-5398
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Authorized Official
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Title or Position | OPTOMETRIST/ OWNER
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Name | DR. SHEETAL BHAGA
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Credential | O.D.
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Telephone | 972-242-6392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7335TG
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License Number State | TX
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