Provider Demographics
NPI:1588795603
Name:BHUPESH HASMUKH DIHENIA MD PA
Entity type:Organization
Organization Name:BHUPESH HASMUKH DIHENIA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BHUPESH
Authorized Official - Middle Name:H
Authorized Official - Last Name:DIHENIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-722-3500
Mailing Address - Street 1:3815 23RD ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1809
Mailing Address - Country:US
Mailing Address - Phone:806-722-3500
Mailing Address - Fax:806-796-0689
Practice Address - Street 1:3815 23RD ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1809
Practice Address - Country:US
Practice Address - Phone:806-722-3500
Practice Address - Fax:806-796-0689
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BHUPESH HASMUKH DIHENIA MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-08
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3156261QM1200X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0050KKOtherBLUECROSS BLUESHEILD
TXDB8435OtherRAILROAD MEDICARE
TX130021086OtherRAILROAD MEDICARE
TX031087201Medicaid
TX1509341-01Medicaid
TX1465629OtherUNITED HEALTHCARE
TX898700OtherHEALTHSMART
TX8J9820OtherBLUECROSS BLUESHIELD
TX111701104OtherFIRST CARE
TX5908577OtherAETNA
TX898700OtherHEALTHSMART
TXDB8435OtherRAILROAD MEDICARE
TXG49599Medicare UPIN