Provider Demographics
NPI:1790301083
Name:BHATT, RUCHA
Entity Type:Individual
Prefix:
First Name:RUCHA
Middle Name:
Last Name:BHATT
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 1:2600 SCOFIELD RIDGE PKWY APT 234
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-7202
Mailing Address - Country:US
Mailing Address - Phone:551-998-7137
Mailing Address - Fax:
Practice Address - Street 1:7201 WYOMING SPRINGS DR STE 300
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4311
Practice Address - Country:US
Practice Address - Phone:512-296-2633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65419183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist