Individual provider · NPI-1

Shiv Bhakta, PA

Physician Assistant · Coppell, TX

NPI number1952912917
StatusActive
Last updated in NPPESJul 24, 2025

Details

NPI
1952912917
Entity type
Individual (NPI-1)
Name
Shiv Bhakta
Credential
PA
Sex
Male
Sole proprietor
No
Enumeration date
Aug 13, 2020
Certification date
Jul 24, 2025
Last updated
Jul 24, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician AssistantPA16244TXYes

Practice location

670 N Macarthur Blvd
Coppell, TX 75019-2710

Phone 972-745-4446 · Fax 972-745-2597

Mailing address

670 N Macarthur Blvd
Coppell, TX 75019-2710

Phone 972-745-4446 · Fax 972-745-2597

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