Healthcare Provider Details

I. General information

NPI: 1326464967
Provider Name (Legal Business Name): GIAN S BEDI MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2014
Last Update Date: 06/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3332 PLAINVIEW ST
PASADENA TX
77504-1906
US

IV. Provider business mailing address

PO BOX 1666
LA MARQUE TX
77568-1666
US

V. Phone/Fax

Practice location:
  • Phone: 832-649-2073
  • Fax: 832-649-2148
Mailing address:
  • Phone: 832-649-2073
  • Fax: 832-649-2148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberM5532
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberM5532
License Number StateTX

VIII. Authorized Official

Name: DR. ASHU SODHI SYAL
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 832-649-2073