Healthcare Provider Details

I. General information

NPI: 1013162924
Provider Name (Legal Business Name): CARLA BEJJANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2008
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 TAUB LOOP 2ND FLOOR- ROOM 2.216
HOUSTON TX
77030-1608
US

IV. Provider business mailing address

1502 TAUB LOOP 2ND FLOOR- ROOM 2.216
HOUSTON TX
77030-1608
US

V. Phone/Fax

Practice location:
  • Phone: 713-873-5270
  • Fax:
Mailing address:
  • Phone: 713-873-5270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number390200000X
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: