Provider Demographics
NPI:1447616206
Name:BHAGAT, JIGISHA D
Entity Type:Individual
Prefix:
First Name:JIGISHA
Middle Name:D
Last Name:BHAGAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 N JUDGE ELY BLVD
Mailing Address - Street 2:APT 324
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:991 N WILLIS ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79603-4620
Practice Address - Country:US
Practice Address - Phone:325-676-2392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-10
Last Update Date:2016-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57072183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist