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General NPI Number Information
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NPI Number | 1497810345
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Entity Type | Organization
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Legal Business Name | GOOD SHEPHERD HEART CARE PLLC
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 1050 N BELT LINE RD SUITE 101
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City | MESQUITE
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State | TX
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Zip | 75149-1782
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Country | US
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Telephone | 972-682-6500
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Fax | 972-682-6501
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Provider Business Mailing Address
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Address Line | 4725 GUS THOMASSON RD SUITE 8,
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City | MESQUITE
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State | TX
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Zip | 75150-1734
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Country | US
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Telephone | 972-682-6500
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Fax | 972-682-6501
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Authorized Official
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Title or Position | PROPRIETOR
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Name | DR. ROBERT JAMES BABUJI
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Credential | M.D.
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Telephone | 972-682-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M5039
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | M5039
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License Number State | TX
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