MEDICARE: DR. BHARATH POLA D.O.

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	Q8608	TX

General Provider Information

NPI Number	:	1780790717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHARATH POLA D.O.

Provider Business Mailing Address
First Line	:	2961 MOSSROCK
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-5119
Country	:	US
Telephone Number	:	210-731-4811
Fax Number	:	210-731-4810

Provider Business Practice Location Address
First Line	:	10307 STATE HIGHWAY 151
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-4557
Country	:	US
Telephone Number	:	210-237-4983
Fax Number	:	210-581-1471

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

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	07/21/2022

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