Provider Demographics
NPI:1114106259
Name:CHAND BHASKER MD PA
Entity Type:Organization
Organization Name:CHAND BHASKER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAND
Authorized Official - Middle Name:
Authorized Official - Last Name:BHASKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-457-8230
Mailing Address - Street 1:800 QUAIL CREEK DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-1634
Mailing Address - Country:US
Mailing Address - Phone:806-457-8230
Mailing Address - Fax:
Practice Address - Street 1:800 QUAIL CREEK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-1634
Practice Address - Country:US
Practice Address - Phone:806-457-8230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8252207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0092KHOtherBLUE CROSS
DD0483OtherRAILROAD MEDICARE
TX00047XMedicare PIN