Provider Demographics
NPI:1487086468
Name:BHAVSAR, NIM PARAS (OD)
Entity type:Individual
Prefix:DR
First Name:NIM
Middle Name:PARAS
Last Name:BHAVSAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MS
Other - First Name:NIM
Other - Middle Name:RAJENDRA
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:12325 TEACUP WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-6128
Mailing Address - Country:US
Mailing Address - Phone:630-697-1491
Mailing Address - Fax:
Practice Address - Street 1:4616 W 38TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-3316
Practice Address - Country:US
Practice Address - Phone:317-328-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003813A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist