Provider Demographics
NPI:1497743462
Name:BAJWA, MOHSIN K (MD)
Entity Type:Individual
Prefix:
First Name:MOHSIN
Middle Name:K
Last Name:BAJWA
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:PO BOX 8307
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77387-8307
Mailing Address - Country:US
Mailing Address - Phone:281-296-8788
Mailing Address - Fax:281-419-1291
Practice Address - Street 1:1125 CYPRESS STATION DR
Practice Address - Street 2:SUITE E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3054
Practice Address - Country:US
Practice Address - Phone:281-537-6300
Practice Address - Fax:281-537-7575
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8902207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036048903Medicaid
TX036048904Medicaid
TX036048904Medicaid
TX8280M2Medicare PIN
TX036048903Medicaid