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General NPI Number Information
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NPI Number | 1407599699
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Entity Type | Individual
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Provider Name | BINNY JAYESH BHAKTA DC
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Gender | Female
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 5501 N LAMAR BLVD STE C111
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City | AUSTIN
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State | TX
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Zip | 78751-1076
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Country | US
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Telephone | 512-766-5054
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Fax |
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Provider Business Mailing Address
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Address Line | 799 ORCUTT RD APT 105
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-6836
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Country | US
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Telephone | 559-759-1345
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 15332
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License Number State | TX
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