MEDICARE: DR. KEERTHANA NAGAVENKATA BOLISETTY MD

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	207W00000X	Ophthalmology Physician	S1985	TX
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	S1985	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407241284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEERTHANA NAGAVENKATA BOLISETTY MD

Provider Business Mailing Address
First Line	:	3824 N TARRANT PKWY STE 310
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-5431
Country	:	US
Telephone Number	:	817-617-7678
Fax Number	:	817-617-7681

Provider Business Practice Location Address
First Line	:	1007 W RANDOL MILL RD STE 110
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-6503
Country	:	US
Telephone Number	:	817-617-7678
Fax Number	:	817-617-7678

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

Provider Enumeration Date	:	03/30/2015
Last Update Date	:	10/23/2022

Similar Medicare Providers

1265558431 — STEPHEN W. RATCLIFF STEPHEN RATCLIFF DDS
Practice Location Address:

1007 W RANDOL MILL RD
ARLINGTON, TX
76012-6503

Practice Phone: 817-274-7875
Practice Fax:

1588597041 — GRACE KLUSTY DPT
Practice Location Address:

1220 N FILLMORE ST
ARLINGTON, VA
22201-6503

Practice Phone: 833-493-4325
Practice Fax:

1093976110 — ANGEL HENDERSON
Practice Location Address:

6503 FALCON RIVER WAY APT 314
ARLINGTON, TX
76001-2837

Practice Phone: 626-469-1482
Practice Fax:

1871128694 — ABU RINKU PHARMD
Practice Location Address:

6503 VINTAGE DR
ARLINGTON, TX
76001-8467

Practice Phone: 646-217-9660
Practice Fax:

1528791449 — ACCESS UNLIMITED LLC
Practice Location Address:

6503 FALCON RIVER WAY APT 314
ARLINGTON, TX
76001-2837

Practice Phone: 626-469-1482
Practice Fax:

1235828203 — CESAR LABOY
Practice Location Address:

1220 N FILLMORE ST
ARLINGTON, VA
22201-6503

Practice Phone: 833-493-4325
Practice Fax:

Directions to “ DR. KEERTHANA NAGAVENKATA BOLISETTY MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.