Provider Demographics
NPI:1841421732
Name:BHATT, VISHWA S (RN, NP-C)
Entity Type:Individual
Prefix:
First Name:VISHWA
Middle Name:S
Last Name:BHATT
Suffix:
Gender:F
Credentials:RN, NP-C
Other - Prefix:
Other - First Name:VISHWA
Other - Middle Name:SATISH
Other - Last Name:BHATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, NP-C
Mailing Address - Street 1:14568 BERKLEE DR
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-5959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0708771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX288026201Medicaid
TXTXB143231Medicare PIN