Provider Demographics
NPI:1457972515
Name:BHAKTA, VIRALBHAI MUKESHBHAI (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:VIRALBHAI
Middle Name:MUKESHBHAI
Last Name:BHAKTA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4222 SPENCER HWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1211
Mailing Address - Country:US
Mailing Address - Phone:626-848-2869
Mailing Address - Fax:
Practice Address - Street 1:16000 PARK TEN PL STE 204
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7296
Practice Address - Country:US
Practice Address - Phone:832-321-4728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1304217225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist