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General NPI Number Information
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NPI Number | 1316463862
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Entity Type | Organization
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Legal Business Name | TEXAS BONE AND JOINT CENTER
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Dates
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Enumeration Date | 08/16/2017
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Last Update Date | 08/16/2017
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Provider Practice Location Address
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Address Line | 407 W INTERSTATE 30
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City | GARLAND
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State | TX
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Zip | 75043-5912
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Country | US
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Telephone | 972-240-8539
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Fax |
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Provider Business Mailing Address
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Address Line | 8251 BEDFORD EULESS RD STE 210
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-7247
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Country | US
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Telephone | 817-656-7827
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEEPAK CHAVDA
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Credential | MD
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Telephone | 817-656-7827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | J5282
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License Number State | TX
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