Provider Demographics
NPI:1245453166
Name:BHATTI, KAMRAN (MD)
Entity type:Individual
Prefix:
First Name:KAMRAN
Middle Name:
Last Name:BHATTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 N I 35
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-5240
Mailing Address - Country:US
Mailing Address - Phone:469-483-4280
Mailing Address - Fax:469-843-4295
Practice Address - Street 1:2400 N I 35
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-5240
Practice Address - Country:US
Practice Address - Phone:469-483-4280
Practice Address - Fax:469-843-4295
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9860207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K5178OtherBCBS
TX1946972-09Medicaid
TX1946972-09Medicaid
TX8K5178OtherBCBS