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General NPI Number Information
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NPI Number | 1962988519
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Entity Type | Individual
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Provider Name | RAJANI BHORE
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Gender | Female
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 4505 SPICEWOOD SPRINGS RD STE 100
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City | AUSTIN
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State | TX
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Zip | 78759-8540
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Country | US
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Telephone | 512-660-5008
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Fax | 512-660-5008
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Provider Business Mailing Address
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Address Line | 4505 SPICEWOOD SPRINGS RD STE 100
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City | AUSTIN
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State | TX
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Zip | 78759-8540
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Country | US
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Telephone | 512-660-5008
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02725200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 36112
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License Number State | TX
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