Provider Demographics
NPI:1073517702
Name:BHATIA, DEVINDER (MD)
Entity Type:Individual
Prefix:
First Name:DEVINDER
Middle Name:
Last Name:BHATIA
Suffix:
Gender:M
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:P.O. BOX 1398 DEPT #03
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090
Mailing Address - Country:US
Mailing Address - Phone:713-850-1190
Mailing Address - Fax:713-850-1327
Practice Address - Street 1:800 PEAKWOOD DR
Practice Address - Street 2:STE 4A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2914
Practice Address - Country:US
Practice Address - Phone:281-397-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL00322086S0129X, 208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046435602Medicaid
TX8P6149OtherBCBS#
TX8C7027Medicare ID - Type Unspecified
TX046435602Medicaid