MEDICARE: RENUKA BHUSARI MPTH

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	225100000X	Physical Therapist	1209907	TX

General Provider Information

NPI Number	:	1285291120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENUKA BHUSARI MPTH

Provider Business Mailing Address
First Line	:	4407 STERLING HEIGHTS LN
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4753
Country	:	US
Telephone Number	:	806-786-5298
Fax Number	:

Provider Business Practice Location Address
First Line	:	5201 S WILLOW DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-4808
Country	:	US
Telephone Number	:	713-721-0297
Fax Number	:

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

Provider Enumeration Date	:	05/27/2019
Last Update Date	:	05/27/2019

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Directions to “ RENUKA BHUSARI MPTH” Practice Location

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