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1588820674

NPI Code Detail

MEDICARE: DR. BADIH ANTONIO KABCHI JITANI

MEDICARE: DR. BADIH ANTONIO KABCHI JITANI

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	T-0531	TX
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	2014-02146	NC
3	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	19011	OTHER	NC	BCBS NC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588820674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BADIH ANTONIO KABCHI JITANI

Provider Business Mailing Address
First Line	:	2116 HOULTON LN
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-3025
Country	:	US
Telephone Number	:	252-295-8773
Fax Number	:

Provider Business Practice Location Address
First Line	:	7777 FOREST LN STE C840
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-2594
Country	:	US
Telephone Number	:	252-744-1600
Fax Number	:

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

Provider Enumeration Date	:	07/29/2008
Last Update Date	:	12/09/2021

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Directions to “ DR. BADIH ANTONIO KABCHI JITANI ” 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.

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