Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | K1975 | TX |
Y | 2080P0204X | Pediatric Emergency Doctor | K1975 | TX |
NPI | 1255401170 |
---|---|
Provider Name | Dr. Bharati Beatrix Bansal |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 19/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113231813 | (05) | TX |
113231814 | CSHCN (01) | TX |