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NPI Code Detail

MEDICARE: BHAVISHA BHAKTA NUNEZ D.O.

MEDICARE:   BHAVISHA  BHAKTA NUNEZ  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
1207V00000XObstetrics & Gynecology Physician2015019331MO
2207V00000XObstetrics & Gynecology PhysicianS3357TX

General Provider Information

NPI Number : 1992191829
Entity Type Code : Individual
Provider Name (Legal Business Name) : BHAVISHA BHAKTA NUNEZ D.O.
Provider Business Mailing Address
First Line : 120 N MILLER RD UNIT 300
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-9173
Country : US
Telephone Number : 817-303-0496
Fax Number :
Provider Business Practice Location Address
First Line : 2800 E BROAD ST STE 212
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-6411
Country : US
Telephone Number : 682-242-8890
Fax Number : 682-242-8896
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2015
Last Update Date : 05/02/2022

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Directions to “ BHAVISHA BHAKTA NUNEZ D.O.” Practice Location

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