Provider Demographics
NPI:1609878461
Name:PERVEZ, BOBBY (MD)
Entity Type:Individual
Prefix:DR
First Name:BOBBY
Middle Name:
Last Name:PERVEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KHAWER
Other - Middle Name:ASAD
Other - Last Name:PERVEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15200 SOUTHWEST FWY
Mailing Address - Street 2:285
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3845
Mailing Address - Country:US
Mailing Address - Phone:281-240-2211
Mailing Address - Fax:281-240-2260
Practice Address - Street 1:15200 SOUTHWEST FWY
Practice Address - Street 2:285
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3845
Practice Address - Country:US
Practice Address - Phone:281-240-2211
Practice Address - Fax:281-240-2260
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1619207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8218K1Medicare ID - Type Unspecified
G41329Medicare UPIN