Individual
JAY BHAGWAN ITALIYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13747 MONTFORT DR STE 320, DALLAS, TX 75240-4454
(469) 306-9764
Mailing address
13747 MONTFORT DR STE 320, DALLAS, TX 75240-4454
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
S6417
TX
Other
Enumeration date
04/03/2018
Last updated
02/15/2024
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