Healthcare Provider Details

I. General information

NPI: 1912025099
Provider Name (Legal Business Name): BHAGIA ORTHODONTICS P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8811 FRANKWAY DR
HOUSTON TX
77096-1900
US

IV. Provider business mailing address

1140 CLEAR LAKE CITY BLVD # C
HOUSTON TX
77062-8103
US

V. Phone/Fax

Practice location:
  • Phone: 281-286-8945
  • Fax:
Mailing address:
  • Phone: 281-286-8945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number20597
License Number StateTX

VIII. Authorized Official

Name: DR. VIJAY BHAGIA
Title or Position: ORTHODONTIST
Credential: D.M.D., M.S.
Phone: 832-545-9376