Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 125058498 | IL |
N | 207T00000X | Neurosurgeon | MD60747516 | WA |
Y | 207T00000X | Neurosurgeon | S0631 | TX |
NPI | 1013228089 |
---|---|
Provider Name | Anita Praful Bhansali |
First Address | Fort Worth, TX 76104-7304 |
Second Address | Fort Worth, TX 76104-7304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2010 |
Last Update Date | 29/09/2021 |