Healthcare Provider Details

I. General information

NPI: 1225188162
Provider Name (Legal Business Name): DALJIT KAUR BAGHA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5760 W LITTLE YORK RD
HOUSTON TX
77091-1112
US

IV. Provider business mailing address

PO BOX 746079
ATLANTA GA
30374-6079
US

V. Phone/Fax

Practice location:
  • Phone: 281-707-7359
  • Fax:
Mailing address:
  • Phone: 127-339-7303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA93800
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberS1557
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: