Provider Demographics
NPI:1306843917
Name:BHAT, LEENA SURESH (MD)
Entity Type:Individual
Prefix:
First Name:LEENA
Middle Name:SURESH
Last Name:BHAT
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:PO BOX 710270
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77271-0270
Mailing Address - Country:US
Mailing Address - Phone:713-772-7779
Mailing Address - Fax:713-772-3915
Practice Address - Street 1:7737 SOUTHWEST FWY
Practice Address - Street 2:SUITE 530
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1807
Practice Address - Country:US
Practice Address - Phone:713-772-7779
Practice Address - Fax:713-772-3915
Is Sole Proprietor?:No
Enumeration Date:2005-06-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0031207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CC311OtherBCBS PROVIDER NUMBER
TXH22872Medicare UPIN
TX8L15706Medicare PIN
TX8B3463Medicare ID - Type Unspecified
TX8CC311OtherBCBS PROVIDER NUMBER
TX8L15834Medicare PIN