MEDICARE: DR. NILANJANA BOSE MD, MBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4301087531	MI

General Provider Information

NPI Number	:	1215142500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NILANJANA BOSE MD, MBA

Provider Business Mailing Address
First Line	:	11914 ASTORIA BLVD STE 355
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-6076
Country	:	US
Telephone Number	:	713-588-1674
Fax Number	:	713-554-2246

Provider Business Practice Location Address
First Line	:	11914 ASTORIA BLVD STE 355
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-6076
Country	:	US
Telephone Number	:	713-588-1674
Fax Number	:	713-554-2246

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	12/15/2025

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