Provider Demographics
NPI:1508152190
Name:BEJJANKI, HARINI PAL (MD)
Entity Type:Individual
Prefix:
First Name:HARINI
Middle Name:PAL
Last Name:BEJJANKI
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 1:17191 ST LUKES WAY STE 260
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-8049
Mailing Address - Country:US
Mailing Address - Phone:936-756-2555
Mailing Address - Fax:936-756-2534
Practice Address - Street 1:17191 ST LUKES WAY STE 260
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8049
Practice Address - Country:US
Practice Address - Phone:936-756-2555
Practice Address - Fax:936-756-2534
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME121077207R00000X, 207RH0005X
TXS6131207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0005XAllopathic & Osteopathic PhysiciansInternal MedicineHypertension Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1I5339OtherMEDICARE
TX419709701Medicaid