Provider Demographics
NPI:1093013864
Name:HANSA BHAKTI MEDLEY M.D. P.A.
Entity Type:Organization
Organization Name:HANSA BHAKTI MEDLEY M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANSA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MEDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-782-2156
Mailing Address - Street 1:8989 WESTHEIMER RD
Mailing Address - Street 2:SUIE 314
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3621
Mailing Address - Country:US
Mailing Address - Phone:713-782-2156
Mailing Address - Fax:713-782-5054
Practice Address - Street 1:8989 WESTHEIMER RD
Practice Address - Street 2:SUIE 314
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3621
Practice Address - Country:US
Practice Address - Phone:713-782-2156
Practice Address - Fax:713-782-5054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2457207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF67556Medicare UPIN