MEDICARE: EMBEE LIFESTYLE DOCS PLLC

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	208D00000X	General Practice Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1699332825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBEE LIFESTYLE DOCS PLLC

Provider Business Mailing Address
First Line	:	4500 BISSONNET ST STE 355
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-3124
Country	:	US
Telephone Number	:	713-592-8900
Fax Number	:	713-592-8904

Provider Business Practice Location Address
First Line	:	4500 BISSONNET ST STE 355
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-3124
Country	:	US
Telephone Number	:	713-592-8900
Fax Number	:	713-592-8904

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. BANDANA N CHAWLA
Credential	:	MD
Telephone Number	:	713-592-8900

Provider Enumeration Date	:	05/22/2019
Last Update Date	:	05/22/2019

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