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General NPI Number Information
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NPI Number | 1790135572
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Entity Type | Organization
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Legal Business Name | CENTER FOR OSTEOPOROSIS AND BONE HEALTH LLC
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Dates
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Enumeration Date | 06/13/2016
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 928 TRAVIS AVE # 104
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City | FORT WORTH
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State | TX
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Zip | 76104-3184
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Country | US
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Telephone | 682-286-1309
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Fax | 817-635-8460
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Provider Business Mailing Address
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Address Line | 928 TRAVIS AVE # 104
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City | FORT WORTH
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State | TX
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Zip | 76104-3184
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Country | US
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Telephone | 682-286-1309
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Fax | 817-635-8460
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GURPREET S. BAJAJ
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Credential | M.D.
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Telephone | 682-286-1309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | L9614
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | L9614
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License Number State | TX
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