Provider Demographics
NPI:1912495086
Name:BHASIN, VIBHA (MD)
Entity Type:Individual
Prefix:DR
First Name:VIBHA
Middle Name:
Last Name:BHASIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3300 NACOGDOCHES RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-3368
Mailing Address - Country:US
Mailing Address - Phone:210-646-0890
Mailing Address - Fax:210-646-9191
Practice Address - Street 1:3300 NACOGDOCHES RD STE 110
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-3368
Practice Address - Country:US
Practice Address - Phone:210-646-0890
Practice Address - Fax:210-646-9191
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0646207ZC0500X, 207ZP0101X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology