Provider Demographics
NPI:1427499953
Name:BHADESHIYA, HARDIK A (DDS)
Entity type:Individual
Prefix:DR
First Name:HARDIK
Middle Name:A
Last Name:BHADESHIYA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7458 LOUIS PASTEUR DR
Mailing Address - Street 2:APT #1105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4533
Mailing Address - Country:US
Mailing Address - Phone:646-535-4337
Mailing Address - Fax:
Practice Address - Street 1:8455 CRESTWAY ROAD SUITE 101
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109
Practice Address - Country:US
Practice Address - Phone:210-202-3280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist