MEDICARE: MANIKUMAR BHEEMARASETTI 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	207R00000X	Internal Medicine Physician	P24244	MD
2	207RC0000X	Cardiovascular Disease Physician	S3120	TX
3	207RI0011X	Interventional Cardiology Physician	P96962	NY
4	207RI0011X	Interventional Cardiology Physician	33233	OK
5	207UN0901X	Nuclear Cardiology Physician	S3120	TX
6	207RI0011X	Interventional Cardiology Physician	S3120	TX

General Provider Information

NPI Number	:	1497986533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANIKUMAR BHEEMARASETTI MD

Provider Business Mailing Address
First Line	:	902 W RANDOL MILL RD STE 200
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-2581
Country	:	US
Telephone Number	:	817-461-3003
Fax Number	:	844-290-4365

Provider Business Practice Location Address
First Line	:	902 W RANDOL MILL RD STE 200
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-2581
Country	:	US
Telephone Number	:	817-461-3003
Fax Number	:	844-290-4365

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

Provider Enumeration Date	:	08/06/2009
Last Update Date	:	09/20/2022

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