Provider Demographics
NPI:1053505131
Name:BHARTI, RACHNA (MD)
Entity Type:Individual
Prefix:
First Name:RACHNA
Middle Name:
Last Name:BHARTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17521 ST LUKES WAY STE 180
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-8040
Mailing Address - Country:US
Mailing Address - Phone:936-266-3505
Mailing Address - Fax:
Practice Address - Street 1:208 OAK DR S STE 200
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5640
Practice Address - Country:US
Practice Address - Phone:979-285-3633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101243104207Q00000X, 208M00000X
TXN6177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080462703Medicaid
KY7100047860Medicaid
WV3810013447Medicaid
TX080462703Medicaid
VAP00640956Medicare PIN