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General NPI Number Information
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NPI Number | 1982456489
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Entity Type | Individual
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Provider Name | BHAVYA ASHISH THAKKAR
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Gender | Male
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Dates
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Enumeration Date | 04/05/2024
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 2700 W PLEASANT RUN RD
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City | LANCASTER
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State | TX
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Zip | 75146-1079
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Country | US
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Telephone | 469-545-7213
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Fax |
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Provider Business Mailing Address
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Address Line | 7346 PARKRIDGE BLVD APT 260
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City | IRVING
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State | TX
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Zip | 75063-8252
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Country | US
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Telephone | 469-545-7213
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1390877
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License Number State | TX
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