Provider Demographics
NPI:1508489618
Name:BHAKTA, POOJA N
Entity Type:Individual
Prefix:
First Name:POOJA
Middle Name:N
Last Name:BHAKTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF INTERNAL MEDICINE 301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0001
Mailing Address - Country:US
Mailing Address - Phone:409-772-2653
Mailing Address - Fax:409-772-5462
Practice Address - Street 1:301 UNIVERSITY BOULEVARD GALVESTON TX 77555-0565
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0001
Practice Address - Country:US
Practice Address - Phone:832-505-1910
Practice Address - Fax:409-747-0064
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10071292207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine