Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | P8576 | TX |
NPI | 1053537290 |
---|---|
Provider Name | Dr. Lokesh Bathla |
First Address | San Antonio, TX 78229-3311 |
Second Address | San Antonio, TX 78229-3707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
330056801 | (05) | TX |
8ED148 | BCBS (01) | TX |