Basic Information
| Provider Information | |||||||||
| NPI: | 1427499953 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BHADESHIYA | ||||||||
| FirstName: | HARDIK | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7458 LOUIS PASTEUR DR | ||||||||
| Address2: | APT #1105 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782294533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6465354337 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8455 CRESTWAY ROAD SUITE 101 | ||||||||
| Address2: | |||||||||
| City: | CONVERSE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102023280 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2013 | ||||||||
| LastUpdateDate: | 07/30/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 29304 | TX | Y | Dental Providers | Dentist |
No ID Information.