=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356010045
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANUJI BEDI NP & COMPANY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/07/2021
-----------------------------------------------------
Last Update Date | 09/07/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5209 LAUREL ST
-----------------------------------------------------
City | BELLAIRE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77401-3926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-522-6576
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5209 LAUREL ST
-----------------------------------------------------
City | BELLAIRE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77401-3926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-522-6576
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ANUJA BEDI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 512-522-6576
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------