Provider Demographics
NPI:1295093854
Name:DILEEP BHATELEY MD PA
Entity type:Organization
Organization Name:DILEEP BHATELEY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:DILEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATELEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:254-803-3561
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:MARLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76661-0150
Mailing Address - Country:US
Mailing Address - Phone:254-803-3561
Mailing Address - Fax:254-803-6066
Practice Address - Street 1:307 LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:MARLIN
Practice Address - State:TX
Practice Address - Zip Code:76661-2365
Practice Address - Country:US
Practice Address - Phone:254-803-3561
Practice Address - Fax:254-803-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0919282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1394272-11Medicaid
TX1394272-11Medicaid