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General NPI Number Information
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NPI Number | 1881904027
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Entity Type | Organization
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Legal Business Name | PRANAV H BHAKTA MD PA
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 17448 HIGHWAY 3 #160
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City | WEBSTER
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State | TX
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Zip | 77598-4197
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Country | US
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Telephone | 281-332-6650
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Fax | 281-332-7588
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Provider Business Mailing Address
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Address Line | PO BOX 220
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City | SEABROOK
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State | TX
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Zip | 77586-0220
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Country | US
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Telephone | 281-332-6650
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Fax | 281-332-7588
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Authorized Official
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Title or Position | DOCTOR
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Name | PRANAV H BHAKTA
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Credential |
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Telephone | 281-332-6650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K2849
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License Number State | TX
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