Provider Demographics
NPI:1619445210
Name:BHANDARI, PRATIVA N
Entity Type:Individual
Prefix:MS
First Name:PRATIVA
Middle Name:N
Last Name:BHANDARI
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 1:29206 GRAND GORGE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5285
Mailing Address - Country:US
Mailing Address - Phone:843-224-9094
Mailing Address - Fax:
Practice Address - Street 1:7629 TIKI DR
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-1548
Practice Address - Country:US
Practice Address - Phone:281-346-0913
Practice Address - Fax:281-346-0913
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138705363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily