Provider Demographics
NPI:1306923206
Name:SOBTI, AJAY (MD)
Entity type:Individual
Prefix:DR
First Name:AJAY
Middle Name:
Last Name:SOBTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 MEDICAL CENTRE DR STE B
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4700
Mailing Address - Country:US
Mailing Address - Phone:817-460-1833
Mailing Address - Fax:817-460-1835
Practice Address - Street 1:901 MEDICAL CENTRE DR STE B
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4700
Practice Address - Country:US
Practice Address - Phone:817-460-1833
Practice Address - Fax:817-460-1835
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1843174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1033786OtherAETNA
TX1278293-05Medicaid
TX010024582OtherRRMCR
TX8J3449OtherBCBS
TX4582186004OtherCIGNA
TXD87490Medicare UPIN
TX00B44JMedicare PIN