1588795603 NPI number — BHUPESH HASMUKH DIHENIA MD PA

Table of content: (NPI 1588795603)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588795603 NPI number — BHUPESH HASMUKH DIHENIA MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BHUPESH HASMUKH DIHENIA MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588795603
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3815 23RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79410-1809
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-722-3500
Provider Business Mailing Address Fax Number:
806-796-0689

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3815 23RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79410-1809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-722-3500
Provider Business Practice Location Address Fax Number:
806-796-0689
Provider Enumeration Date:
03/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DIHENIA
Authorized Official First Name:
BHUPESH
Authorized Official Middle Name:
H
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
806-722-3500

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  K3156 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM1200X , with the licence number: K3156 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0050KK . This is a "BLUECROSS BLUESHEILD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: DB8435 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 130021086 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 031087201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1509341-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1465629 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 898700 . This is a "HEALTHSMART" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8J9820 . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 111701104 . This is a "FIRST CARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5908577 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com