Provider Demographics
NPI:1023190055
Name:BHATTI, AHMED S (MD)
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:S
Last Name:BHATTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 PALUXY RD STE A
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-5689
Mailing Address - Country:US
Mailing Address - Phone:817-408-3197
Mailing Address - Fax:817-579-3926
Practice Address - Street 1:3710 E US HIGHWAY 377 STE 116
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76049-7616
Practice Address - Country:US
Practice Address - Phone:817-579-3994
Practice Address - Fax:817-579-3993
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9859207RS0012X, 207RP1001X, 207R00000X
NY228837207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY228837OtherNEW YORK STATE LISENCE
TXM9859OtherPHYSICIAN PERMIT
TX1255569471OtherGROUP NPI NUMBER
TX206878502Medicaid
TX206878502Medicaid
TX1255569471OtherGROUP NPI NUMBER
TX0A4699Medicare PIN
TX331257YXRQMedicare PIN
TX8F21982Medicare PIN