Provider Demographics
NPI:1619151024
Name:BHUPESH HASMUKH DIHENIA MD PA
Entity type:Organization
Organization Name:BHUPESH HASMUKH DIHENIA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:BHUPESH
Authorized Official - Middle Name:H
Authorized Official - Last Name:DIHENIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-722-3500
Mailing Address - Street 1:3815 23RD ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1809
Mailing Address - Country:US
Mailing Address - Phone:806-722-5350
Mailing Address - Fax:806-796-0689
Practice Address - Street 1:1801 HINKLE DR
Practice Address - Street 2:SUITE #100
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-1791
Practice Address - Country:US
Practice Address - Phone:940-382-7345
Practice Address - Fax:940-382-7349
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BHUPESH HASMUKH DIHENIA MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-20
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150934103Medicaid
TX150934103Medicaid