Individual
DEEPAK BOMMISETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1441 N BECKLEY AVE, DALLAS, TX 75203
(214) 947-2455
(214) 947-2390
Mailing address
1441 N BECKLEY AVE, DALLAS, TX 75203-1201
(214) 947-2455
(214) 947-2390
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R8868
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2016
Last updated
12/13/2019
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