Provider Demographics
NPI:1780916775
Name:BARGOTY, BASHAR H (MD)
Entity type:Individual
Prefix:DR
First Name:BASHAR
Middle Name:H
Last Name:BARGOTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BASHAR
Other - Middle Name:H
Other - Last Name:ALBARGHUTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 207830
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-4670
Mailing Address - Country:US
Mailing Address - Phone:888-412-2649
Mailing Address - Fax:405-792-8910
Practice Address - Street 1:6473 KINGSTON PIKE # 6473
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4832
Practice Address - Country:US
Practice Address - Phone:865-588-8831
Practice Address - Fax:865-588-8841
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN52587207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ014644Medicaid
TN103I296545Medicare PIN