Individual
SMITA BHASKARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1400 S COULTER ST, AMARILLO, TX 79106-1786
(806) 414-9800
(806) 354-5689
Mailing address
1400 WALLACE BLVD, AMARILLO, TX 79106-1708
(806) 414-9800
(806) 354-5689
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
57.014466
OH
208000000X
Pediatrics Physician
Q3851
TX
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
Q3851
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200586940 A
—
OK
05
—
21277036
—
NM
05
—
345359901
—
TX
05
—
345359902
—
TX
Enumeration date
09/15/2008
Last updated
09/10/2015
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