Basic Information
| Provider Information | |||||||||
| NPI: | 1043538481 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAUDHARI | ||||||||
| FirstName: | BHARTI | ||||||||
| MiddleName: | RUGNATH | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CHAUDHARI | ||||||||
| OtherFirstName: | BHARTIBEN | ||||||||
| OtherMiddleName: | RUGNATHBHAI | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1213 TEMPLEMORE DR | ||||||||
| Address2: | |||||||||
| City: | KELLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762482547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8478944278 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1575 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761044901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145442780 | ||||||||
| FaxNumber: | 6145441727 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2010 | ||||||||
| LastUpdateDate: | 09/11/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Q0023 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.