Provider Demographics
NPI:1376949214
Name:BHATTA, SARMILA
Entity Type:Individual
Prefix:MRS
First Name:SARMILA
Middle Name:
Last Name:BHATTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARMILA
Other - Middle Name:
Other - Last Name:BHATA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:PO BOX 7339
Mailing Address - Street 2:UT SCHOOL OF NURSING FAMILY WELLNESS CENTER
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78713-7339
Mailing Address - Country:US
Mailing Address - Phone:512-386-3335
Mailing Address - Fax:512-386-3333
Practice Address - Street 1:5301 ROSS RD
Practice Address - Street 2:UT SCHOOL OF NURSING FAMILY WELLNESS CENTER
Practice Address - City:DEL VALLE
Practice Address - State:TX
Practice Address - Zip Code:78617-3288
Practice Address - Country:US
Practice Address - Phone:512-386-3335
Practice Address - Fax:512-386-3333
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX754197163W00000X
TXAP126034363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse