MEDICARE: HANSA BHAKTI MEDLEY M.D. P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	J2457	TX

General Provider Information

NPI Number	:	1093013864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANSA BHAKTI MEDLEY M.D. P.A.

Provider Business Mailing Address
First Line	:	8989 WESTHEIMER RD
Second Line	:	SUIE 314
City	:	HOUSTON
State	:	TX
Zip	:	77063-3621
Country	:	US
Telephone Number	:	713-782-2156
Fax Number	:	713-782-5054

Provider Business Practice Location Address
First Line	:	8989 WESTHEIMER RD
Second Line	:	SUIE 314
City	:	HOUSTON
State	:	TX
Zip	:	77063-3621
Country	:	US
Telephone Number	:	713-782-2156
Fax Number	:	713-782-5054

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. HANSA B MEDLEY
Credential	:	M.D.
Telephone Number	:	713-782-2156

Provider Enumeration Date	:	03/03/2011
Last Update Date	:	03/03/2011

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