MEDICARE: DR. BERAHT RAJA THAPA DO

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	207Q00000X	Family Medicine Physician	W3625	TX
2	207Q00000X	Family Medicine Physician	34014829	OH

General Provider Information

NPI Number	:	1437686037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BERAHT RAJA THAPA DO

Provider Business Mailing Address
First Line	:	247 S BURNETT RD STE 210
Second Line	:
City	:	SPRINGFIELD
State	:	OH
Zip	:	45505-2663
Country	:	US
Telephone Number	:	937-864-2742
Fax Number	:	937-864-2775

Provider Business Practice Location Address
First Line	:	400 W ARBROOK BLVD STE 101
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-3175
Country	:	US
Telephone Number	:	817-801-1456
Fax Number	:	817-801-0594

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

Provider Enumeration Date	:	05/15/2017
Last Update Date	:	05/07/2026

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