Healthcare Provider Details

I. General information

NPI: 1487569547
Provider Name (Legal Business Name): POOJA BHULA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 WALLINGWOOD DR BLDG 12
AUSTIN TX
78746-6932
US

IV. Provider business mailing address

1017 N BROADWAY AVE
ADA OK
74820-2036
US

V. Phone/Fax

Practice location:
  • Phone: 512-501-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number94820
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: