Organization
DEEPTHI PARVATANENI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEEPTHI PARVATANENI (MD)
(740) 645-3798
Entity
Organization
Contact information
Practice address
6913 CAMP BOWIE BLVD STE 171, FORT WORTH, TX 76116-7165
(817) 731-6121
Mailing address
PO BOX 16524, FORT WORTH, TX 76162-0524
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730473935
NPI
TX
Enumeration date
03/03/2021
Last updated
03/03/2021
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