Provider Demographics
NPI:1235219270
Name:BHATIA, LAXMAN (MD)
Entity type:Individual
Prefix:
First Name:LAXMAN
Middle Name:
Last Name:BHATIA
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 1:4300 CITY POINT DR STE 201
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8338
Mailing Address - Country:US
Mailing Address - Phone:817-284-8222
Mailing Address - Fax:817-595-5718
Practice Address - Street 1:4300 CITY POINT DR
Practice Address - Street 2:SUITE 200
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8380
Practice Address - Country:US
Practice Address - Phone:817-255-1940
Practice Address - Fax:817-255-1977
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8331207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX128845808Medicaid
TX128845807Medicaid
TX128845807Medicaid
TX128845807Medicaid