Provider Demographics
NPI:1871147991
Name:BHAKTA, RAJ V (OD)
Entity type:Individual
Prefix:DR
First Name:RAJ
Middle Name:V
Last Name:BHAKTA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 2706
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-2706
Mailing Address - Country:US
Mailing Address - Phone:956-661-9000
Mailing Address - Fax:956-630-0149
Practice Address - Street 1:2518 W TRENTON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8070
Practice Address - Country:US
Practice Address - Phone:956-661-9000
Practice Address - Fax:956-630-0149
Is Sole Proprietor?:No
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX9753T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist