Provider Demographics
NPI:1598436933
Name:BHORA CLINIC PA
Entity Type:Organization
Organization Name:BHORA CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:K
Authorized Official - Last Name:BHORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-721-4449
Mailing Address - Street 1:5430 CLOUDS CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4933
Mailing Address - Country:US
Mailing Address - Phone:281-721-4449
Mailing Address - Fax:928-212-1869
Practice Address - Street 1:11711 SHADOW CREEK PKWY STE 147
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7234
Practice Address - Country:US
Practice Address - Phone:281-721-4449
Practice Address - Fax:928-212-1869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty