MEDICARE: ASHISH BHARGAVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1003654864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHISH BHARGAVA

Provider Business Mailing Address
First Line	:	701 E BLUFF ST APT 7102
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-2373
Country	:	US
Telephone Number	:	509-475-8826
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 E BLUFF ST APT 7102
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-2373
Country	:	US
Telephone Number	:	509-475-8826
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2024
Last Update Date	:	07/17/2024

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Directions to “ ASHISH BHARGAVA ” Practice Location

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