Physician Compare National (NPI:1457551459)

HEALTHCARE PROVIDER: SAMIR BHAKTA O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1457551459
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5395833883
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071116000329
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BHAKTA
	Individual professional last name
Provider First Name	SAMIR
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4109 S STAPLES ST
	Group Practice or individual's line 1 address
City	CORPUS CHRISTI
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	784115500
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y