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General NPI Number Information
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NPI Number | 1629890819
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Entity Type | Individual
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Provider Name | DEEPAK BHANDARI PHD
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Gender | Male
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1400 N SAM HOUSTON PKWY E STE 158
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City | HOUSTON
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State | TX
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Zip | 77032-2959
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Country | US
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Telephone | 832-770-4686
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Fax |
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Provider Business Mailing Address
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Address Line | 5686 PRINCETON RUN TRL
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City | TUCKER
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State | GA
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Zip | 30084-8465
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Country | US
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Telephone | 865-773-8205
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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