Provider Demographics
NPI:1184928772
Name:BHAVSAR, SHILPA N (PA-C)
Entity type:Individual
Prefix:
First Name:SHILPA
Middle Name:N
Last Name:BHAVSAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 LOUIS HENNA BLVD
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-7074
Mailing Address - Country:US
Mailing Address - Phone:512-456-7209
Mailing Address - Fax:512-456-7413
Practice Address - Street 1:799 LOUIS HENNA BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-7074
Practice Address - Country:US
Practice Address - Phone:512-456-7209
Practice Address - Fax:512-456-7413
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06607363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant