Provider Demographics
NPI:1982013439
Name:BIBINAGAR, DEEPTHI (MD)
Entity Type:Individual
Prefix:DR
First Name:DEEPTHI
Middle Name:
Last Name:BIBINAGAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6551 HARRIS PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-6105
Mailing Address - Country:US
Mailing Address - Phone:817-624-3500
Mailing Address - Fax:682-708-7225
Practice Address - Street 1:6551 HARRIS PKWY STE 110
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-6105
Practice Address - Country:US
Practice Address - Phone:817-624-3500
Practice Address - Fax:682-708-7225
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-08
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7148207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease