Healthcare Provider Details

I. General information

NPI: 1053054726
Provider Name (Legal Business Name): SANJEEB BHANDARI MBBS, MD, CHM, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 E RIDGE RD STE 1
MCALLEN TX
78503-1518
US

IV. Provider business mailing address

PO BOX 4830
EDINBURG TX
78540-4830
US

V. Phone/Fax

Practice location:
  • Phone: 956-631-8875
  • Fax: 956-683-1502
Mailing address:
  • Phone: 956-631-8875
  • Fax: 956-683-1502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberV4881
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number76622-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: