Healthcare Provider Details

I. General information

NPI: 1477759215
Provider Name (Legal Business Name): ROBIN RASHMI BHAVSAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 E 29TH ST STE 100
BRYAN TX
77802-2507
US

IV. Provider business mailing address

2800 S TEXAS AVE SUITE 202
BRYAN TX
77802-5361
US

V. Phone/Fax

Practice location:
  • Phone: 979-774-3041
  • Fax: 979-774-3053
Mailing address:
  • Phone: 979-774-2060
  • Fax: 979-776-5914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberP3509
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: