Individual ProviderDeepthi ParvataneniFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address923 College Ave, Suite 103, Fort Worth, TX 76104-3050(972) 544-6600PECOS EnrollmentBased on the most recent information from CMS, provider Deepthi Parvataneni is legally eligible to order and refer claims for Part B, HHA and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1730473935Provider TypeIndividualFull NameParvataneni, DeepthiCredentialMDGenderFemaleSole ProprietorYesEnumeration Date6/6/2011Last Updated12/5/2016Contact InformationPractice LocationPractice Address923 College Ave, Suite 103, Fort Worth, TX 76104-3050Phone(972) 544-6600Fax(972) 544-6604Mailing LocationMailing Address923 College Ave, Suite 103, Fort Worth, TX 76104-3050Phone(972) 544-6600Fax(972) 544-6604Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseQ3260TexasCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer