Provider Demographics
NPI:1023711751
Name:UPRETI, BABITA
Entity type:Individual
Prefix:
First Name:BABITA
Middle Name:
Last Name:UPRETI
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 1:7016 AVERY LN
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-1120
Mailing Address - Country:US
Mailing Address - Phone:682-553-5416
Mailing Address - Fax:
Practice Address - Street 1:7016 AVERY LN
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-1120
Practice Address - Country:US
Practice Address - Phone:682-553-5416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX766180363LG0600X
TX1117021363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty