MEDICARE: CHANVINDER PAHWA-BHOLA OD

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	152W00000X	Optometrist	8220-T	TX

General Provider Information

NPI Number	:	1275975260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANVINDER PAHWA-BHOLA OD

Provider Business Mailing Address
First Line	:	10415 W GRAND PKWY S STE 100B
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-8718
Country	:	US
Telephone Number	:	346-202-7616
Fax Number	:	346-369-8540

Provider Business Practice Location Address
First Line	:	10415 W GRAND PKWY S STE 100B
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-8718
Country	:	US
Telephone Number	:	346-202-7616
Fax Number	:	346-369-8540

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

Provider Enumeration Date	:	07/19/2013
Last Update Date	:	12/05/2025

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