Healthcare Provider Details

I. General information

NPI: 1205576253
Provider Name (Legal Business Name): ROMA BHANDARKAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 07/02/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17189 INTERSTATE 45 SOUTH, SUITE 235
WOODLANDS TX
77385-1501
US

IV. Provider business mailing address

404 MILAM CREEK DR
KYLE TX
78640-3358
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-5800
  • Fax:
Mailing address:
  • Phone: 214-549-9028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV7828
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: