Provider Demographics
NPI:1467456962
Name:BHATELEY, DILEEP C (MD)
Entity Type:Individual
Prefix:DR
First Name:DILEEP
Middle Name:C
Last Name:BHATELEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:514 S BONHAM ST
Mailing Address - Street 2:STE G
Mailing Address - City:MEXIA
Mailing Address - State:TX
Mailing Address - Zip Code:76667-3664
Mailing Address - Country:US
Mailing Address - Phone:254-803-3561
Mailing Address - Fax:254-883-6066
Practice Address - Street 1:307 LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:MARLIN
Practice Address - State:TX
Practice Address - Zip Code:76661
Practice Address - Country:US
Practice Address - Phone:254-803-3561
Practice Address - Fax:254-883-6066
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0919208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1394272-12Medicaid
TX1333676-05Medicaid
TX0815318-01Medicaid
TX1394272-12Medicaid
TX00N92UMedicare PIN
TX0815318-01Medicaid