Provider Demographics
NPI:1568615011
Name:BHARGAVA, ANKUSH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ANKUSH
Middle Name:
Last Name:BHARGAVA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18403 WINDSOR LAKES DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-3511
Mailing Address - Country:US
Mailing Address - Phone:832-331-6936
Mailing Address - Fax:
Practice Address - Street 1:16000 PARK TEN PL
Practice Address - Street 2:SUITE #204
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7292
Practice Address - Country:US
Practice Address - Phone:832-321-4728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2016-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1172001225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist