Provider Demographics
NPI:1316463862
Name:TEXAS BONE AND JOINT CENTER
Entity type:Organization
Organization Name:TEXAS BONE AND JOINT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEEPAK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-656-7827
Mailing Address - Street 1:8251 BEDFORD EULESS RD STE 210
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7247
Mailing Address - Country:US
Mailing Address - Phone:817-656-7827
Mailing Address - Fax:
Practice Address - Street 1:407 W INTERSTATE 30
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-5912
Practice Address - Country:US
Practice Address - Phone:972-240-8539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5282207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty