Individual
DR. DIPESH RAJ BISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 8TH AVE RM 770, FORT WORTH, TX 76104-4110
(817) 922-1770
(817) 922-1775
Mailing address
1400 8TH AVE RM 770, FORT WORTH, TX 76104-4110
(817) 922-1770
(817) 922-1775
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
Q3149
TX
208M00000X
Hospitalist Physician
Q3149
TX
390200000X
Student in an Organized Health Care Education/Training Program
MT195059
PA
Other
Enumeration date
06/30/2009
Last updated
04/25/2023
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