Provider Demographics
NPI:1538356365
Name:BHAGA, SHEETAL (OD)
Entity type:Individual
Prefix:DR
First Name:SHEETAL
Middle Name:
Last Name:BHAGA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7638 STONEBROOK PKWY
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-1003
Mailing Address - Country:US
Mailing Address - Phone:972-712-1010
Mailing Address - Fax:
Practice Address - Street 1:7638 STONEBROOK PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1003
Practice Address - Country:US
Practice Address - Phone:972-712-1010
Practice Address - Fax:972-712-1011
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1597152W00000X
TX7335TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1902852346OtherGROUP NPI
TX1538356365OtherNPI
TX84840QOtherBCBS
TX90168237OtherDPS
TX1234530001OtherDME PTAN
TX11805172OtherCAQH
TX7335-TGOtherLICENSE
TX00E41YOtherGROUP PTAN
TX00E41YOtherGROUP PTAN
TX1234530001OtherDME PTAN