Provider Demographics
NPI:1134124696
Name:BHAT, KRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:
Last Name:BHAT
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 1:19411 MCKAY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5708
Mailing Address - Country:US
Mailing Address - Phone:281-548-7313
Mailing Address - Fax:281-446-6818
Practice Address - Street 1:19411 MCKAY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5708
Practice Address - Country:US
Practice Address - Phone:281-548-7313
Practice Address - Fax:281-446-6818
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2008-02-11
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
TXE8330207RS0012X, 207K00000X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133025001Medicaid
TX133025001Medicaid
TX5283450001Medicare NSC
TX00JM17Medicare ID - Type Unspecified