Provider Demographics
NPI:1457399842
Name:BHATTI, FARRUKH L (MD)
Entity Type:Individual
Prefix:
First Name:FARRUKH
Middle Name:L
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 1:7021 SHINNECOCK HILLS DR
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-7123
Mailing Address - Country:US
Mailing Address - Phone:817-805-6474
Mailing Address - Fax:
Practice Address - Street 1:7021 SHINNECOCK HILLS DR
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-7123
Practice Address - Country:US
Practice Address - Phone:817-805-6474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005001622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC134094Medicare UPIN