Provider Demographics
NPI:1275826208
Name:NAVJOT BAJWA MD
Entity Type:Organization
Organization Name:NAVJOT BAJWA MD
Other - Org Name:CHILDREN MEDICAID CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAVJOT
Authorized Official - Middle Name:
Authorized Official - Last Name:BAJWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-691-4100
Mailing Address - Street 1:11751 ALTA VISTA RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6407
Mailing Address - Country:US
Mailing Address - Phone:817-623-2012
Mailing Address - Fax:817-623-2009
Practice Address - Street 1:11751 ALTA VISTA RD
Practice Address - Street 2:SUITE 103
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76244-6407
Practice Address - Country:US
Practice Address - Phone:817-623-2012
Practice Address - Fax:817-623-2009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5790208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty