Provider Demographics
NPI:1841268992
Name:BHARGAVA, DEEPIKA (MD)
Entity type:Individual
Prefix:
First Name:DEEPIKA
Middle Name:
Last Name:BHARGAVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 TEAGUE DRIVE
Mailing Address - Street 2:STE 212
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2653
Mailing Address - Country:US
Mailing Address - Phone:903-892-0751
Mailing Address - Fax:903-892-9694
Practice Address - Street 1:1800 TEAGUE DRIVE
Practice Address - Street 2:STE 212
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2653
Practice Address - Country:US
Practice Address - Phone:903-892-0751
Practice Address - Fax:903-892-9694
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM10232084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0066NGOtherBLUE SHIELD
TX179853001Medicaid
TX179853001Medicaid
TX0066NGOtherBLUE SHIELD