Provider Demographics
NPI:1205835022
Name:DIHENIA, BHUPESH HASMUKH (MD)
Entity Type:Individual
Prefix:
First Name:BHUPESH
Middle Name:HASMUKH
Last Name:DIHENIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 23RD ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1809
Mailing Address - Country:US
Mailing Address - Phone:806-722-3500
Mailing Address - Fax:806-796-0689
Practice Address - Street 1:3815 23RD ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410
Practice Address - Country:US
Practice Address - Phone:806-722-3500
Practice Address - Fax:806-796-0689
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK31562084N0400X, 2084N0400X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0050KKOtherBLUECROSS BLUESHIELD
TX130021086OtherRAILROAD MEDICARE
TX1509341-02Medicaid
TX898700OtherHEALTHSMART
TX1509341-01Medicaid
TX8J9820OtherBLUECROSS BLUESHIELD
TX031087201Medicaid
NM42855055OtherNEW MEXICO MEDICAID
TXP00249371OtherRAILROAD MEDICARE
TX5908577OtherAETNA
TXDB8435OtherRAILROAD MEDICARE
TX111701104OtherFIRST CARE
TX1465629OtherUNITED HEALTHCARE
TX0310872-02Medicaid
TX1509341-02Medicaid
TXFTX184Medicare PIN
TX0050KKOtherBLUECROSS BLUESHIELD