MEDICARE: GURDAVE HTU

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1407699507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GURDAVE HTU

Provider Business Mailing Address
First Line	:	6227 DUKE TRAIL LN
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4466
Country	:	US
Telephone Number	:	281-202-3375
Fax Number	:

Provider Business Practice Location Address
First Line	:	6227 DUKE TRAIL LN
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4466
Country	:	US
Telephone Number	:	281-202-3375
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	BHAVJEET KHARA
Credential	:
Telephone Number	:	281-202-3375

Provider Enumeration Date	:	06/17/2024
Last Update Date	:	06/17/2024

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