MEDICARE: DR. PRATIMA R BAKSHI 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	P7064	TX
2	207R00000X	Internal Medicine Physician	048972	GA

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	:	1528057742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRATIMA R BAKSHI MD

Provider Business Mailing Address
First Line	:	3434 SWISS AVE
Second Line	:	SUITE 330
City	:	DALLAS
State	:	TX
Zip	:	75204-6251
Country	:	US
Telephone Number	:	214-828-5070
Fax Number	:	214-828-5071

Provider Business Practice Location Address
First Line	:	3434 SWISS AVE
Second Line	:	SUITE 330
City	:	DALLAS
State	:	TX
Zip	:	75204-6251
Country	:	US
Telephone Number	:	214-828-5070
Fax Number	:	214-828-5071

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	01/09/2023

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