Provider Demographics
NPI:1043569130
Name:SATHYA P. BHANDARI, M.D. P.A.
Entity Type:Organization
Organization Name:SATHYA P. BHANDARI, M.D. P.A.
Other - Org Name:LIBERTY PAIN ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:SATHYA
Authorized Official - Middle Name:P
Authorized Official - Last Name:BHANDARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-355-9038
Mailing Address - Street 1:1021 LONG PRAIRIE RD STE 402
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-4399
Mailing Address - Country:US
Mailing Address - Phone:972-355-9038
Mailing Address - Fax:844-221-1862
Practice Address - Street 1:1021 LONG PRAIRIE RD STE 402
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4399
Practice Address - Country:US
Practice Address - Phone:972-355-9038
Practice Address - Fax:844-221-1862
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SATHYA P. BHANDARI, M.D. P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-05
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3289208100000X
208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB163032Medicare PIN