Provider Demographics
NPI:1558439505
Name:VACHHANI, BHUPATRAI G (MD)
Entity Type:Individual
Prefix:DR
First Name:BHUPATRAI
Middle Name:G
Last Name:VACHHANI
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 1:6503 ANTOINE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-1203
Mailing Address - Country:US
Mailing Address - Phone:713-686-1835
Mailing Address - Fax:713-686-0379
Practice Address - Street 1:6503 ANTOINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-1203
Practice Address - Country:US
Practice Address - Phone:713-686-1835
Practice Address - Fax:713-686-0379
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1792207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100279202Medicaid
TX100279202Medicaid
TX890576Medicare PIN