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General NPI Number Information
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NPI Number | 1558677690
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Entity Type | Individual
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Provider Name | BANTOO SEHGAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/26/2010
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Last Update Date | 05/03/2025
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Provider Practice Location Address
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Address Line | 800 12TH AVE STE 200
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City | FORT WORTH
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State | TX
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Zip | 76104-2519
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Country | US
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Telephone | 214-631-9881
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Fax | 469-482-2526
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Provider Business Mailing Address
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Address Line | 800 12TH AVE STE 200
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City | FORT WORTH
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State | TX
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Zip | 76104-2519
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Country | US
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Telephone | 214-631-9881
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Fax | 694-822-5264
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 249831-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | PT 12022
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | A112987
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | R0125
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License Number State | TX
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