Healthcare Provider Details
I. General information
NPI: 1831519818
Provider Name (Legal Business Name): UMA KRISHNA BHAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/17/2014
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18951 N MEMORIAL DR
HUMBLE TX
77338-4217
US
IV. Provider business mailing address
18951 N MEMORIAL DR
HUMBLE TX
77338-4217
US
V. Phone/Fax
- Phone: 281-540-7700
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | R4189 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | R4189 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: