Provider Demographics
NPI:1417940016
Name:SINGH, JESSIE BHATIA (MD)
Entity Type:Individual
Prefix:MR
First Name:JESSIE
Middle Name:BHATIA
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:JASBIR
Other - Middle Name:BHATIA
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 7104
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-7104
Mailing Address - Country:US
Mailing Address - Phone:325-795-9140
Mailing Address - Fax:325-795-9150
Practice Address - Street 1:1111 INDUSTRIAL BLVD
Practice Address - Street 2:BLDG 2
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-7929
Practice Address - Country:US
Practice Address - Phone:325-795-9140
Practice Address - Fax:325-795-9150
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF77002084A0401X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1711632Medicaid
D13084Medicare UPIN
TX1711632Medicaid