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NPI Code Detail

MEDICARE: DEEPTHI PARVATANENI MD PA

MEDICARE: DEEPTHI PARVATANENI MD PA
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
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11730473935OTHERTXNPI

General Provider Information

NPI Number : 1679168546
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEEPTHI PARVATANENI MD PA
Provider Business Mailing Address
First Line : PO BOX 16524
Second Line :
City : FORT WORTH
State : TX
Zip : 76162-0524
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6913 CAMP BOWIE BLVD STE 171
Second Line :
City : FORT WORTH
State : TX
Zip : 76116-7165
Country : US
Telephone Number : 817-731-6121
Fax Number :
Authorized Official
Title or Position : MD
Name : DEEPTHI PARVATANENI
Credential :
Telephone Number : 740-645-3798
Provider Enumeration Date : 03/03/2021
Last Update Date : 03/03/2021

Similar Medicare Providers

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Practice Location Address:
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1215255146 — MR. RYAN SAMUEL STEPINOFF PA-C
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1700170867 — BIJU BENNY MATHEW M.D
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1982133799 — ALISHIA LINDSAY SCHMITT PT, DPT
Practice Location Address:
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1790328979 — MANALI HEALTHCARE PLLC
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Directions to “DEEPTHI PARVATANENI MD PA ” Practice Location

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