Bolisetty, Keerthana Nagavenkata

Bolisetty, Keerthana Nagavenkata is an individual health care provider with primary practice located at 1007 W Randol Mill Rd Ste 110 , Arlington TX 76012-6503. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is her primary health care specialty. Bolisetty, Keerthana Nagavenkata can be contacted via phone (817) 617-7678.

Contact Information

Primary practice address
1007 W Randol Mill Rd Ste 110 Arlington TX 76012-6503
Phone: (817) 617-7678
Fax: (817) 617-7678
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X S1985 Texas
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X S1985 Texas

Profile Details

NPI number 1407241284
LBN Legal business name Bolisetty, Keerthana Nagavenkata
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2015
Last updated Oct 23rd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407241284 NPPES
Texas MEDICAID 400383205

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