Individual
JAYA D BATHINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1400 S MAIN ST FL 1, FORT WORTH, TX 76104-4909
(817) 702-6926
Mailing address
PO BOX 732973, DALLAS, TX 75373-6666
(817) 702-2450
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD2015-0139
NM
207RC0000X
Cardiovascular Disease Physician
MD2015-0139
NM
207RC0000X
Cardiovascular Disease Physician
Primary
R5357
TX
Other
Enumeration date
07/21/2009
Last updated
08/31/2022
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