Provider Demographics
NPI:1124058664
Name:BHATIA, SUBIR S (MD)
Entity type:Individual
Prefix:
First Name:SUBIR
Middle Name:S
Last Name:BHATIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:510 RANCH TRL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-4878
Mailing Address - Country:US
Mailing Address - Phone:972-899-8070
Mailing Address - Fax:972-899-8072
Practice Address - Street 1:510 RANCH TRL
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-4878
Practice Address - Country:US
Practice Address - Phone:972-899-8070
Practice Address - Fax:972-899-8072
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2023-05-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM2903207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AS770OtherBLUE CROSS BLUE SHIELD
TX8F7580Medicare PIN
TX8F7581Medicare PIN
TX8F7582Medicare PIN
TX8AS770OtherBLUE CROSS BLUE SHIELD