Provider Demographics
NPI:1033120373
Name:BHAKTA, HETUL D (DC)
Entity Type:Individual
Prefix:DR
First Name:HETUL
Middle Name:D
Last Name:BHAKTA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5866 S STAPLES ST
Mailing Address - Street 2:STE 101
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-3769
Mailing Address - Country:US
Mailing Address - Phone:361-985-2225
Mailing Address - Fax:361-985-2285
Practice Address - Street 1:5866 S STAPLES ST
Practice Address - Street 2:STE 101
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3769
Practice Address - Country:US
Practice Address - Phone:361-985-2225
Practice Address - Fax:361-985-2285
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10152111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor